How is clevidipine used to treat hypertensive emergencies?

Updated: Feb 05, 2018
  • Author: Christy Hopkins, MD, MPH; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

Clevidipine, a dihydropyridine CCB, is administered IV for rapid and precise BP reduction. [25] It is rapidly metabolized in the blood and tissues and does not accumulate in the body. Initiate IV infusion of clevidipine at 1-2 mg/hour; titrate the dose at short intervals (ie, 90 seconds) initially by doubling the dose.

As the BP approaches its goal, increase the clevidipine dose by less than double, and lengthen the time between dose adjustments to every 5-10 minutes. An approximately 1-2 mg/hour increase produces an additional 2-4 mm Hg decrease in SBP. Typically, the therapeutic response is achieved with 4-6 mg/hour, although severe hypertension may require higher doses. Most patients have received maximum doses of 16 mg/hour or less; experience is limited with short-term dosing as high as 32 mg/hour. Because of lipid load restrictions, do not exceed 1000 mL or an average of 21 mg/hour within a 24-hour period; experience is limited with use beyond 72 hours.


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