Objective: Prospective recording of IV nicardipine efficacy and safety as a first-line antihypertensive drug in neonates.
Patients: Twenty neonates (15 preterm) with systemic hypertension due to steroids administration (n = 14), polycystic kidney disease (n = 1), renal vein thrombosis (n = 1), coarctation of aorta (n = 1) or from an undetermined cause (n = 3).
Interventions: The initial nicardipine dosage was 0.5 microg/kg/min in 17 patients. The maximal nicardipine dosage was 0.74+/-0.41 microg/kg/ min (0.5-2.0). The duration of treatment was 14.6+/-11.6 days.
Results: Systolic blood pressure significantly decreased after 3, 6, 12, 24 and 48 h of nicardipine treatment (-20+/-11%, -19+/-10%, -20+/-8%, -20+/-10% and -20+/-12%, respectively). The decrease in blood pressure remained significant over the subsequent days of treatment. No hypotension or other clinical side effects were observed.
Conclusions: Both additional pharmacokinetic and pharmacodynamic studies remain mandatory to improve the dosage regimens and assess the efficacy and safety of nicardipine infusion in hypertensive neonates.