Intravenous use of the calcium-channel blocker nicardipine as second-line treatment in severe, early-onset pre-eclamptic patients

Abstract

This evaluation shows that nicardipine is a potent antihypertensive drug and can be used for temporizing management in severe, early-onset pre-eclampsia when other antihypertensive drugs have failed.

Umbilical cord blood concentrations of labetalol hydrochloride administered to patients with pregnancy induced hypertension, and subsequent neonatal findings

“…3,4) Because labetalol also decreases cerebral perfusion pressure without influencing the cerebral flow index, 5) it may help prevent severe preeclampsia. 1) At international society meetings, labetalol injection has been presented as a first-choice drug [6][7][8][9][10] and, with the recent revision of the package inserts, may be increasingly administered to PIH patients in Japan.…”

Ketanserin versus dihydralazine for the treatment of severe hypertension in early-onset preeclampsia: a double blind randomized controlled trial

“…After discontinuation of the study, nicardipine has become the first line treatment in the Erasmus Medical Centre and the Isala Clinic. Based on our experience in the last 9 years (submission of our data expected in 2015) and other reports [16,17] nicardipine seems to be an effective and safe treatment option for treatment of severe hypertension in pregnancy.…”

“…In total 14 patients were subsequently treated with the escape medication, nicardipine. All of these patients reached target blood pressure and pregnancy was prolonged [16]. The need for rescue medication was significantly higher in the ketanserin group compared to dihydralazine (11/15 vs 3/15, p < 0.001), RR 3.7 (1.3-10.6).…”

“…For patients safety the dosage was adjusted which was the forerunner of the premature closure of the trial. After 30 inclusions, the study was stopped and the randomization code was broken because of the high rate of persistent hypertension using ketanserin, the high rate of maternal side effects using dihydralazine and the apparent succesful use of the rescue drug nicardipine, without severe side effects [16].…”

État des connaissances : prise en charge thérapeutique de la prééclampsie

“…La nicardipine (Loxen ® ) est utilisée aussi bien par voie veineuse à la dose de 0,5 à 1 mg par heure que par voie orale avec une efficacité comparable [23]. Néanmoins, il semble que la nicardipine intraveineuse puisse être plutôt considérée comme une arme thérapeu-tique efficace à la dose de 3 à 9mg par heure, mais plutôt de deuxième ligne après échec d'autres traitements (dihydralazine ou labetalol) [24]. En effet, les effets secondaires maternels rapportés ne sont pas exceptionnels avec tachycardie, flushes, nausées, céphalées et vertiges [25].…”