Nicardipine

Drug Levels and Effects:




Summary of Use during Lactation:


Because of the low levels of nicardipine in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. No special precautions are required.


Drug Levels:


Maternal Levels.

Ten women were treated with oral nicardipine 4 to 14 days postpartum. Four received an immediate-releaseproduct 40 to 80 mg daily, and 6 received asustained-releaseproduct 100 to 150 mg daily. Another woman received intravenous nicardipine 120 mg daily. The authors calculated that the infants received an average of 0.073% of the maternal weight-adjusted dose with the oral dosage and 0.14% of the maternal weight-adjusted dose with the intravenous dosage. They estimated that the average dosage that an infant would receive is about 0.3% of the projected infant dosage.[1]

Seven women received intravenous infusions of nicardipine for an average of 1.9 days in the immediate postpartum period as therapy for pre-eclampsia. Thirty-four milk samples were obtained at unspecified times; nicardipine was undetectable (<5 mcg/L) in 82% of samples. Four women receiving 1 to 6.5 mg/hour of nicardipine had 6 milk samples with detectable nicardipine ranging from 5.1 to 18.5 mcg/L. The highest concentration of 18.5 mcg/L was found in a woman receiving 5.5 mg/hour of nicardipine. The authors estimated that the maximum dose that could be received by a breastfed infant was less than 0.3 mcg daily or between 0.015 to 0.004% of a therapeutic dose in a 1 kg infant.[2]

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


Relevant published information was not found as of the revision date.


Possible Effects on Lactation:


Relevant published information was not found as of the revision date.


Alternate Drugs to Consider:


Nifedipine


References:


1. Jarreau PH, Le Beller C, Guillonneau M et al. Excretion of nicardipine in human milk. Paediatr Perinat Drug Ther. 2000;4:28-30.
2. Bartels P, Hanff L, Mathot R et al. Nicardipine in pre-eclamptic patients: placental transfer and disposition in breast milk. BJOG. 2006; 114:230-3. PMID:17166219



Substance Identification:




Substance Name:

Nicardipine

CAS Registry Number:

55985-32-5

Drug Class:


  • Antihypertensive Agents

  • Calcium Channel Blockers

  • Vasodilator Agents


  • Administrative Information:




    LactMed Record Number:


    408


    Last Revision Date:


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