Clevidipine

Hypertension

Hypertension Infusion solution 1-2 mg/hr (2-4 mL/hr), double dose q90sec initially; as blood pressure approaches goal, increase dose by less than doubling, and increase time between adjustments to q5-10min Maintenance: 4-6 mg/hr; not to exceed 21 mg/hr (1000 mL within 24 hour period)

Renal Impairment Dose adjustment not necessary

Hypertension 1-2 mg/hr (2-4 mL/hr), double dose q90sec initially; as blood pressure approaches goal, increase dose by less than doubling, and increase time between adjustments to q5-10min Maintenance: 4-6 mg/hr; not to exceed 21 mg/hr (1000 mL within 24 hour period)

Hepatic Impairment Dose adjustment not necessary

IV Administration Milky white emulsion No preservatives-use within 4 hr of puncturing stopper Doesn't need dilution

Hypersensitivity to drug, soy or egg products Defective lipid metabolism Acte pancreatitis if accompanied by hyperlipidemia Severe aortic stenosis

Maintain aseptic technique. Discard the unused portion 12 hours after stopper puncture. Hypotension and reflex tachycardia are potential consequences of rapid upward titration of Cleviprex. Dihydropyridine calcium channel blockers can produce negative inotropic effects and exacerbate heart failure. Cleviprex gives no protection against the effects of abrupt beta-blocker withdrawal. Patients who receive prolonged Cleviprex infusions and are not transitioned to other antihypertensive therapies should be monitored for the possibility of rebound hypertension for at least 8 hours after the infusion is stopped. Monitoring Parameters: Monitor blood pressure and heart rate during infusion and until vital signs stabilize. Monitor heart failure patients carefully.

Not Classi Pregnancy Available data based on post-marketing reports with use in pregnant women are not sufficient to inform a drug-associated risk for major birth defects, miscarriage, or adverse maternal or fetal outcomes; there are risks to mother and fetus associated with poorly controlled hypertension in pregnancy Hypertension in pregnancy increases maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (eg, need for cesarean section and postpartum hemorrhage); hypertension increases fetal risk for intrauterine growth restriction and intrauterine death; pregnant women with hypertension should be carefully monitored and managed accordingly Animal data In animal studies, drug was associated with increased incidences of intrauterine deaths, slightly reduced fetal weight, retarded skeletal development, abortion, and embryo lethality at doses higher than the expected human dose No evidence of embryo-fetal malformation was found with continuous IV infusion of clevidipine administered to pregnant rats and rabbits during the period of organogenesis at multiples of 2.8 and 7.6 times the expected human dose of 16 mg/hr respectively Lactation There are no data on presence of drug in human milk, effects on breastfed infant, or on milk production

Contraindicated (0) Serious (1) lofexidine

>10% AFib (21%) Nausea (21%) 1-10% Acute renal failure (9%) Headache (6%) Vomiting (3%) <1% Cardiac arrest Myocardial infarction Postmarketing Reports Increased blood triglycerides Ileus Nausea Hypersensitivity Hypotension Reflex tachycardia Decreased oxygen saturation (possible pulmonary shunting)

Calcium channel blocker (dihydropyridine): inhibits transmembrane influx of extracellular Ca ions across membranes of myocardial cells and vascular smooth muscle cells, without changing serum calcium concentrations, resulting in inhibition of cardiac and vascular smooth muscle contraction, thereby dilating main coronary and systemic arteries