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In Hypertensive Emergencies

You Have No Time to Waste

In the treatment of hypertensive emergencies, Ready-to-Use CARDENE I.V. provides smooth, predictable blood pressure control.1 It also may offer the emergency department (ED) a number of additional benefits.

  • Allows rapid intervention2,3

    • No waiting for a pharmacy-mixed bag2,3

    • Supports after-pharmacy-hours medication needs3

  • Supports compliance with The Joint Commission standards and American Society of Health-System Pharmacists guidelines for dispensing and storing medications4,5

    • When possible, medications shall be available in ready-to-administer form4,5

  • Ready-to-Use CARDENE I.V. is the only available premixed formulation of nicardipine hydrochloride. This calcium channel blocker is recommended in all the following guidelines:

    • 2009 American Heart Association (AHA)/American Stroke Association (ASA) Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage6

    • 2007 AHA/ASA Guidelines for:

      • The Management of Spontaneous Intracerebral Hemorrhage in Adults7

      • The Early Management of Adults With Ischemic Stroke8

Ready-to-Use CARDENE I.V. is indicated for short-term management of hypertension when oral therapy is not feasible or desirable.1

 

ED Physician Benefits

  • Does not significantly increase intracranial pressure9,10

  • Maintains or increases cardiac output1

  • Eliminates medication admixture errors

 

ED Nurse Benefits

  • Enables practical point-of-use storage2

  • Provides convenient dosing and titration1

  • Eliminates medication admixture errors

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Important Safety Information
Close monitoring of the blood pressure is required during therapy. CARDENE I.V. is contraindicated in patients with known hypersensitivity to the drug and in patients with advanced aortic stenosis. Reduction of diastolic pressure and reduced afterload may worsen rather than improve myocardial oxygen balance. Caution is advised when administering CARDENE I.V. to patients with impaired renal or hepatic function, in combination with a beta-blocker in patients with congestive heart failure, or portal hypertension. Observe caution in patients with significant left ventricular dysfunction due to possible negative inotropic effect. CARDENE I.V. gives no protection against the dangers of abrupt beta-blocker withdrawal; beta-blocker dosage should be gradually reduced. Levels of cyclosporine should be closely monitored during therapy. The most common side effects of CARDENE I.V. are headache (14.6%), hypotension (5.6%), nausea/vomiting (4.9%), and tachycardia (3.5%). Less frequent adverse effects, in each case occurring at 1.4%, include ECG abnormalities, postural hypotension, ventricular extrasystoles, injection-site reaction, dizziness, sweating and polyuria.

Please see full prescribing information.

References: 1. CARDENE I.V. prescribing information, 2008. EKR Therapeutics, Bedminster, NJ. 2. Ruble J. Impact safety, efficiency, and the bottom line with premixed IV products. Pharma Purchasing Prod. February 2008:34-38, vi. 3. Fanikos J, Erickson A, Munz KE, et al. Observations on the use of ready-to-use and point-of-care activated parenteral products in automated dispensing cabinets in U.S. hospitals. Am J Health-Syst Pharm. 2007;64(19):2037-2043. 4. Rich DS. New JCAHO medication management standards for 2004. Am J Health-Syst Pharm. 2004;61(13):1349-1358. 5. American Society of Health-System Pharmacists. ASHP guidelines: minimum standard for pharmacies in hospitals. Am J Health-Syst Pharm. 1995;52(23):2711-2717. 6. Bederson JB, Connolly ES Jr, Batjer HH, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 2009;40(3):994-1025. doi:10.1161/STROKEAHA.108.191395. 7. Broderick J, Connolly S, Feldmann E, et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Stroke. 2007;38(6):2001-2023. 8. Adams HP Jr, del Zoppo G, Alberts MJ, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke. 2007;38(5):1655-1711. 9. Nishiyama T. Yokoyama T, Matsukawa T, Hanaoka K. Continuous nicardipine infusion to control blood pressure after evacuation of acute cerebral hemorrhage. Can J Anaesth. 2000;47(12):1196-1201. 10. Narotam PK, Puri V, Roberts JM, et al. Management of hypertensive emergencies in acute brain disease: evaluation of the treatment effects of intravenous nicardipine on cerebral oxygenation. J Neurosurg. 2008;109(6):1065-1074.

 

© EKR Therapeutics, Inc. All rights reserved. August 2009.