Clevidipine (Intravenous)

Clevidipine is also known under US brand name Cleviprex and is a drug that is used in the treatment of high blood pressure, otherwise known as hypertension.

Overview

This drug is used to treat high blood pressure. High blood pressure adds to the workload of the arteries and heart. If this pressure continues for a long period of time, the arteries and heart may begin to not function effectively. This can result in damage to the blood vessels of the heart, brain, and kidneys which can result in heart failure, a stroke or kidney failure. High blood pressure can also increase your risk of a heart attack. These problems are less likely to occur if blood pressure is well controlled.

Clevidipine is whats known as a calcium channel blocker which works by changing the movement of calcium into the cells of the blood vessels and heart. This results in the blood vessels relaxing, thus increasing the supply of oxygen and blood to the heart. This reduces the overall workload of the heart. This medication is only available via prescription from your doctor and is available in the dosage form of emulsion for intravenous use.

Condition treated

  • High blood pressure

Type of medicine

  • Emulsion for intravenous use

Side Effects

Along with its intended effects, the use of clevidipine can bring about some unwanted side effects. These side effects are ranked below in terms of rare and more common. You should consult with your doctor or a healthcare professional urgently if you begin to experience any of the following side effects whilst clevidipine.

More common

  • Confusion
  • Agitation
  • Decreased urine output
  • Feelings of depression
  • Fainting
  • Dizziness
  • Irregular or fast heartbeat
  • Headache
  • Irritability
  • Hostility
  • Lethargy
  • Muscle twitching
  • Loss of consciousness
  • Nausea
  • Seizures (convulsions)
  • Rapid weight gain
  • Stupor
  • Unusual weakness or tiredness
  • Swelling of the ankles, face or hands

Rare side effects

  • Difficult or labored breathing
  • Chest discomfort or pain
  • Shortness of breath
  • Stopping of the heart
  • Pain or discomfort in the jaw, arms, back, or neck
  • Sweating
  • Unconsciousness
  • Tightness in the chest
  • Very low pulse or blood pressure
  • Wheezing
  • Vomiting

Remember you can report any side effects you may experience whilst taking clevidipine to the FDA on 1-800-FDA-1088. Remember there may be other side effects that are not listed above that could be affecting you. If you are worried, contact your local pharmacist or a healthcare professional for advice.

Dosage

The final dosage of clevidipine will depend on a number of factors. This includes your age, height, weight, previous medical history, the severity of your condition and how you react to the first dosage.

Typical Adult Dose for Hypertension

The typical dose is an IV infusion of 1-2 mg/hour (2- 4 ml per hour)

The dose may be doubled at short intervals of ninety seconds initially. As the blood pressure approaches the goal measure, the doses should be less than doubling and intervals between the doses should rise to around five to ten minutes. A general increase of around 1 - 2 mg per hour produces an additional decrease of two to four mmHg in systolic pressure.

A maintenance will be specific to each individual and will depend on the therapeutic response that's desired. However, for most patients, this occurs around doses four and 6 mg per hour. Those who suffer from difficult hypertension may require doses up to thirty-two mg/hour.

Maximum dose: Most patients are given a maximum dose of 16 mg/hour or less. There is little experience with infusion durations beyond 72 hours at any dose.

Interactions

Interactions between drugs may affect how well the medicine works and can produce unwanted side effects. It is therefore important that you inform your doctor or healthcare professional of all the current drugs you are taking, including prescription/non-prescription drugs, vitamins, and herbal remedies. You should also give a list of past medications you have taken and a history of any medical conditions you or close family members have suffered from too.

Below are some of the most common drugs that interact with clevidipine. You should let your doctor know if you are taking any of these medications. Do not start, stop or change doses of any medications you are taking without discussing it with a healthcare professional first.

  • Dolasetron
  • Tizanidine
  • Amitriptyline
  • Acebutolol
  • Amifostine
  • Amobarbital
  • Apomorphine
  • Amoxapine
  • Apraclonidine ophthalmic
  • Asenapine
  • Aripiprazole
  • Aspirin
  • Avanafil
  • Atenolol
  • Acetylcarbromal
  • Alfentanil
  • Aldesleukin
  • Alprazolam
  • Baclofen
  • Betaxolol ophthalmic
  • Betamethasone
  • Betaxolol
  • Bisoprolol
  • Brigatinib
  • Brexpiprazole
  • Brimonidine ophthalmic
  • Budesonide
  • Brimonidine topical
  • Buprenorphine
  • Buspirone
  • Bupropion
  • Butabarbital
  • Butorphanol
  • Butalbital
  • Canagliflozin
  • Cabergoline
  • Chlorpromazine
  • Clobazam
  • Chlorzoxazone
  • Clomipramine
  • Clorazepate
  • Clonazepam
  • Clozapine
  • Codeine
  • Carisoprodol
  • Cariprazine
  • Carteolol
  • Carvedilol
  • Carteolol ophthalmic
  • Ceritinib
  • Chloral hydrate
  • Chlormezanone
  • Chlorphenesin
  • Corticorelin
  • Dapagliflozin
  • Cortisone
  • Corticotropin
  • Cosyntropin
  • Cyclobenzaprine
  • Crizotinib
  • Deflazacort
  • Desipramine
  • Diphenhydramine
  • Dexamethasone
  • Diazepam
  • Doxepin
  • Dexmedetomidine
  • Doxepin topical
  • Dezocine
  • Donepezi
  • Diatrizoate
  • Epoprostenol
  • Empagliflozin
  • Esmolol
  • Ethanol
  • Estazolam
  • Ethchlorvynol
  • Fentanyl
  • Fenoldopam
  • Fluphenazine
  • Fingolimod
  • Fludrocortisone
  • Flurazepam
  • Furazolidone
  • Halazepam
  • Galantamine
  • Haloperidol
  • Hydrocortisone
  • Heroin
  • Hydromorphone
  • Hydroxyzine
  • Hydrocodone
  • Ibuprofen
  • Imipramine
  • Iloperidone
  • Iloprost
  • Iodamide
  • Iopanoic acid
  • Iodipamide
  • Iothalamate
  • Ipodate
  • Ioxaglate
  • Isocarboxazid
  • Labetalol
  • Ivabradine
  • Levobetaxolol ophthalmic
  • Levodopa
  • Levorphanol
  • Levomethadyl acetate
  • Licorice
  • Lithium
  • Linezolid
  • Magnesium sulfate
  • Maraviroc
  • Maprotiline
  • Meperidine
  • Methotrimeprazine
  • Methocarbamol
  • Metipranolol ophthalmic
  • Methylprednisolone
  • Metoprolol
  • Molindone
  • Midazolam
  • Mirtazapine
  • Morphine
  • Nefazodone
  • Nortriptyline
  • Nalbuphine
  • Nebivolol
  • Olanzapine
  • Opium
  • Oxazepam
  • Orphenadrine
  • Oxycodone
  • Paliperidone
  • Oxymorphone
  • Paraldehyde
  • Penbutolol
  • Pasireotide
  • Pentazocine
  • Pentobarbital
  • Quazepam
  • Propoxyphene
  • Quetiapine
  • Riociguat
  • Rasagiline
  • Remifentanil
  • Safinamide
  • Selegiline
  • Secobarbital
  • Selexipag
  • Tetrabenazine
  • Thalidomide
  • Trazodone
  • Temazepam
  • Tetrofosmin
  • Zaleplon
  • Treprostinil
  • Ziprasidone
  • Zolpidem
  • Vardenafil

Other diseases

If you suffer from any of the listed medical conditions, you need to inform your doctor.

  • Allergy to soy products, soybeans, eggs, or egg products
  • Severe aortic stenosis
  • Lipid metabolism problems such as lipoid nephrosis, hyperlipemia, pancreatitis. This medication should not be used in patients who suffer from these conditions.
  • Hypotension (low blood pressure) - caution should be exercised as it could make the condition worse.
  • Heart failure

Warnings

  • Heart rate and blood pressure and heart rate should be closely monitored during infusion of this drug and until vital signs are shown as stable. Those who are not transitioned to another antihypertensive treatment following prolonged infusions of clevidipine should be monitored for at least eight hours after the infusion is stopped. This is to monitor rebound hypertension.
  • Continued blood pressure monitoring is recommended for those who are transitioned onto an oral antihypertensive agent until the final blood pressure desire is reached.
  • Note that dihydropyridine calcium channel blockers can cause some negative inotropic effects that can make heart failure worse. Those with heart failure should be monitored more closely.
  • Clevidipine contains about 0.2 g of lipid per mL. Those who suffer from a significant lipid metabolism disorder may require a decrease in concurrently administered lipids or lipid intake restrictions in order to compensate for the amount infused as formation of the clevidipine formulation.

Use in the pediatric population

Efficacy and safety have not been established in those patients who are less than 18 years of age.

Use in Geriatric population

Appropriate studies have not indicated any geriatric-specific problems that could limit the usefulness of clevidipine in older people. However, it is worth noting that elderly patients are more likely to have age-related liver, kidney or heart problems, which could mean an adjustment in dose may be required for those elderly patients who are receiving clevidipine.

Use in pregnancy and breast feeding

Clevidipine is under FDA pregnancy category C. This means it's not known whether this drug is harmful to an unborn baby. Before you receive this medication, you should inform your doctor or a healthcare professional that you are pregnant.

It's not known whether clevidipine transfers into breast milk whilst breastfeeding an infant, or if it could harm the infant. Before using this drug you should inform your doctor that you are breast-feeding a baby.

Note that in an emergency situation it may not be possible to tell your caregivers you are breastfeeding or pregnant before you are treated with clevidipine. It's therefore important that you ensure any doctor or healthcare professional who is caring for your baby or you during knows you have taken clevidipine.

If you taking a beta-blocker (such as Coreg, Betapace Corgard, Inderal, Dutoprol, InnoPran, Normodyne, Tenormin, Lopressor Tenoretic, Toprol, or others), don't suddenly stop taking the beta blocker without consulting your doctor first. You may find you need to use less before you can completely stop taking the medication. If you stop a beta blocker too quickly, it can result in serious heart problems that the use of clevidipine cannot prevent.

Storage

This medication is taken in a clinical setting, such as a hospital. Clevidipine should be stored in a refrigerator at 36°F- 46°F (2°C- 8°C). Unopened vials are stable for two months at room temperature. The drug should be used within a twelve hour period once it has been punctured. Any tubing and unused medication should be discarded. This medication should be stored away from light and it should not be allowed to freeze.

Summary

When used correctly, clevidipine is successful in treating patients who suffer from high blood pressure. There are many drugs and diseases that can interact with this drug so it is vital you inform your doctor of everything you are currently taken, so to prevent any unwanted side effects and the drug is effective in treatment. Caution should be taken if pregnant or breastfeeding and you should consult with your doctor before proceeding with this drug. This drug is given in a hospital setting and you will be closely monitored to ensure your blood pressure reaches the desired level without any problems.