Nicardipine

Effective treatment for high blood pressure and angina can significantly reduce the risk of serious heart and cardiovascular events over time. Nicardipine tablets are a prescription-only calcium channel blocker used in adults for the treatment of hypertension and the prophylaxis of chronic stable angina pectoris. Nicardipine belongs to the dihydropyridine class and provides cardiovascular therapy through its action on blood vessel smooth muscle. A prescription can only be issued following a clinical consultation.

Nicardipine tablets are an oral prescription medicine containing nicardipine hydrochloride as the active ingredient. Nicardipine is a second-generation dihydropyridine calcium channel blocker. It is structurally related to nifedipine but has a higher degree of selectivity for vascular smooth muscle compared to cardiac muscle, similar to other dihydropyridines in this series.

Nicardipine immediate release tablets are licensed in the UK for two indications. The first is the treatment of mild to moderate hypertension. The second is the prophylaxis of chronic stable angina pectoris, where it helps to prevent episodes of chest pain by improving blood supply to the heart muscle and reducing the workload on the heart. This page covers the immediate release tablet formulation (20 mg and 30 mg). A modified release capsule formulation of nicardipine also exists but is a separate product with different dosing and is not covered here.

Nicardipine is available as a generic medicine. Two strengths are available through this service: 20 mg and 30 mg tablets. Because nicardipine immediate release tablets require dosing three times daily, patients should be aware of this schedule before starting treatment.

Nicardipine lowers blood pressure and helps to prevent angina episodes by acting on calcium channels in blood vessel walls and, to a lesser extent, the heart.

Calcium Channel Blockade and Vasodilation

In smooth muscle cells lining blood vessel walls, calcium enters through voltage dependent calcium channels, triggering contraction and narrowing of the vessel. Nicardipine blocks these channels selectively in vascular smooth muscle. By preventing calcium from entering, nicardipine stops the contraction signal. Blood vessels relax and widen (vasodilation), reducing the resistance against which the heart pumps and lowering blood pressure.

Benefits for Angina

In angina, the heart muscle does not receive enough oxygen rich blood, typically because the coronary arteries have narrowed. Nicardipine improves blood flow through the coronary arteries by reducing their resistance and preventing vasospasm. It also reduces the workload on the heart by lowering peripheral vascular resistance, which means the heart requires less oxygen to maintain blood circulation. These effects together help to prevent the chest pain associated with stable angina.

Nicardipine has a relatively short duration of action compared to some other calcium channel blockers, which is why the immediate-release formulation is taken three times daily. This dosing schedule maintains consistent plasma levels throughout the day and provides continuous blood pressure lowering and angina protection.

Always take nicardipine exactly as your prescriber instructs. The information below summarises key points from the current UK SmPC. Read the Patient Information Leaflet supplied with your medicine before starting treatment.

• Nicardipine immediate release tablets are taken three times daily. This is different from many other blood pressure medicines, which are taken once or twice daily. It is important to take the tablets regularly at approximately the same times each day to maintain consistent blood levels.
• Nicardipine should be taken with or just after food. Food reduces the rapid absorption that can cause flushing and other vasodilatory side effects.
• Swallow the tablet whole with a glass of water.
• If you miss a dose, take it as soon as you remember. If it is close to the time of your next scheduled dose, skip the missed dose and continue as normal. Do not take two doses at once.
• Do not stop taking nicardipine without speaking to your prescriber first. For hypertension, stopping suddenly can cause blood pressure to rise again. For angina, stopping suddenly may cause worsening of chest pain.
• Taking nicardipine three times daily requires careful planning. Spacing the doses approximately eight hours apart helps to maintain even blood levels throughout the day. Your prescriber will confirm the most appropriate timing for your daily routine. Attend all follow up appointments so your blood pressure and angina symptoms can be reviewed.

Nicardipine immediate release tablets are available in two strengths. The appropriate dose is determined by your prescriber based on the condition being treated and your response to treatment.

Nicardipine 20 mg Tablets

The 20 mg tablet is the standard starting dose. The usual starting dose is 20 mg three times daily for both hypertension and angina. This allows the prescriber to assess your blood pressure response and tolerability before any increase is considered. Many patients will achieve adequate blood pressure or angina control at the 20 mg three times daily dose.

Nicardipine 30 mg Tablets

The 30 mg tablet is used if the 20 mg dose does not provide adequate control. The dose may be increased to 30 mg three times daily after at least three days on the lower dose. The maximum recommended dose is 30 mg three times daily (a total daily dose of 90 mg). All dose adjustments are made by your prescriber. Do not change your dose without medical advice.

The total daily dose range for nicardipine immediate-release tablets is 60 mg to 90 mg, given in three divided doses. Because of the three times daily dosing requirement, patients who find this schedule difficult to maintain may wish to discuss with their prescriber whether an alternative formulation or a different medicine with a simpler dosing schedule would better suit their lifestyle and support long-term treatment adherence.

Like all medicines, nicardipine can cause side effects, although not everyone experiences them. The information below is based on the current UK SmPC. Refer to the Patient Information Leaflet for the full list of side effects.

Common Side Effects (may affect up to 1 in 10 people)

• Flushing or a feeling of warmth, often in the face. This is caused by the vasodilatory action of the medicine and is more common with immediate release formulations.
• Headache, particularly at the start of treatment
• Dizziness or lightheadedness, particularly on standing up quickly
• Palpitations or an increased heart rate (tachycardia). If this is troublesome or persistent, contact your prescriber.
• Peripheral oedema (swelling of the ankles and lower legs)
• Nausea

Uncommon Side Effects (may affect up to 1 in 100 people)

• Low blood pressure (hypotension)
• Fatigue
• Skin rash or itching
• Gastrointestinal discomfort including abdominal pain or diarrhoea

Serious Side Effects: Seek Urgent Medical Attention

Go to your nearest accident and emergency department or call 999 immediately if you experience:

• A significant worsening of chest pain, particularly in the early days of treatment. Calcium channel blockers can occasionally worsen angina when first starting. Seek medical advice promptly if chest pain worsens after starting nicardipine.
• Signs of a severe allergic reaction such as sudden swelling of the face, lips, tongue, or throat, or difficulty breathing
• Severe low blood pressure causing fainting or collapse

Report any suspected side effect to your prescriber, pharmacist, or via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk.

Nicardipine Tablets May Be Suitable If You:

• Are an adult with a confirmed diagnosis of mild to moderate hypertension
• Have chronic stable angina pectoris and require prophylactic treatment for angina relief
• Are already prescribed nicardipine and require a repeat prescription through an online prescribing service

Nicardipine Tablets Are Not Suitable If You:

• Have unstable or acute angina. Nicardipine immediate release tablets are contraindicated for use in acute angina attacks and are not licensed for unstable angina.
• Have had a myocardial infarction (heart attack) within the preceding four weeks
• Have advanced aortic stenosis
• Are pregnant or planning to become pregnant. Nicardipine is not recommended during pregnancy. Contact your prescriber immediately if you become pregnant while taking nicardipine.
• Are breastfeeding
• Have decompensated heart failure
• Have a known allergy or hypersensitivity to nicardipine, other dihydropyridines, or any excipient listed in the SmPC
• Are under 18 years of age

Tell your prescriber about all medicines you take, including over the counter products and herbal supplements. The following interactions are of particular clinical importance:

• Ciclosporin: nicardipine can increase ciclosporin blood levels. The SmPC advises that this combination requires close monitoring of ciclosporin levels. Dose adjustment of ciclosporin may be necessary.
• CYP3A4 inhibitors such as itraconazole, ketoconazole, erythromycin, and HIV protease inhibitors: these can increase nicardipine blood levels and may increase the risk of side effects.
• Cimetidine: increases nicardipine blood levels. Patients taking cimetidine alongside nicardipine should be monitored for enhanced blood pressure lowering.
• Other antihypertensive medicines: additive blood pressure lowering effects should be considered. Nicardipine may be used alongside beta blockers or other antihypertensives, but the combination requires prescriber assessment.
• Digoxin: nicardipine may increase digoxin blood levels. Monitoring of digoxin levels may be required.

Your prescriber will review all current medicines during the clinical assessment before any prescription is considered.

Nicardipine is a Prescription Only Medicine. The clinical consultation is the essential first step. A prescription will only be issued if a registered prescriber concludes, based on their individual assessment of your circumstances, that nicardipine is clinically appropriate for you.

During your online consultation with Pharmacy Planet, a registered prescriber will review your clinical information. This includes your blood pressure history, whether you have a diagnosis of chronic stable angina, your current medicines, any relevant cardiac history, and other aspects of your medical background. Based on this assessment, the prescriber will decide whether nicardipine is appropriate, which strength suits your needs, or whether a different approach is more suitable for your cardiovascular therapy. Not all consultations will result in a prescription.

If you are already under the care of your GP or a cardiologist for hypertension or angina, please keep them informed of any medicines prescribed through online services. This supports safe and coordinated BP regulation and heart health management.

• Store below 25°C.
• Store in the original packaging to protect from moisture and light.
• Keep out of the sight and reach of children.
• Do not use after the expiry date printed on the packaging.
• Do not dispose of medicines via household waste or wastewater. Return unused or out of date tablets to your pharmacist for safe disposal.
• Full storage instructions are provided in the Patient Information Leaflet supplied with your medicine.

The table below compares calcium channel blocker tablets. Dihydropyridines (such as amlodipine and nifedipine) act mainly on blood vessels. Non-dihydropyridines (verapamil and diltiazem) also slow the heart rate and have antiarrhythmic properties.

Important: This comparison is for general information only and does not replace medical advice. A prescriber will decide which treatment is suitable for you following an online consultation.

Pharmacy Planet is a GPhC-registered online pharmacy providing access to prescription medicines through a clinically led consultation process. Our registered prescribers and pharmacists are committed to patient safety, clinical accuracy, and responsible prescribing.

We follow GPhC standards, MHRA guidance, and ASA advertising regulations in all aspects of our service. Every prescription is reviewed and dispensed by qualified healthcare professionals. We provide clear, factual information to help patients understand their antihypertensive medication and make informed decisions about their cardiovascular therapy and heart health.

If you have questions about nicardipine or any other medicine, our pharmacy team is available to help. We are committed to transparent, patient centred care.

References

1. Electronic Medicines Compendium (eMC). Nicardipine hydrochloride 20 mg and 30 mg tablets — Summary of Product Characteristics. https://www.medicines.org.uk/emc. Accessed May 2026.
2. National Institute for Health and Care Excellence (NICE). Hypertension in adults: diagnosis and management. NICE guideline NG136. https://www.nice.org.uk/guidance/ng136. Accessed May 2026.
3. NHS. High blood pressure (hypertension). https://www.nhs.uk/conditions/high-blood-pressure-hypertension. Accessed May 2026.
4. Joint Formulary Committee. British National Formulary (BNF). Nicardipine hydrochloride. BMJ Group and Pharmaceutical Press. https://bnf.nice.org.uk. Accessed May 2026.
5. Medicines and Healthcare products Regulatory Agency (MHRA). Yellow Card — report a side effect. https://yellowcard.mhra.gov.uk. Accessed May 2026.