Isradipine
Mechanism :
Inhibits calcium ion from entering the “slow channels” or select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization, producing relaxation of vascular smooth muscle, resulting in coronary vasodilation and reduced blood pressure.
Indication :
Contraindications :
Hypersensitivity to isradipine or any component of the formulation.
Dosing :
Off-label use:
Oral: Initial:
0.15-0.2 mg/kg/day in 3-4 divided doses; maximum 0.8 mg/kg/day, up to 20 mg daily.
Adverse Effect :
Headache, edema, flushing, tachycardia, palpitations, dizziness, skin rash, nausea, abdominal pain, diarrhea, weakness, urinary frequency, dyspnea.
Interaction :
Ondansetron: Isradipine and ondansetron both increase QTc interval.
Mefloquine: Mefloquine increases toxicity of isradipine by QTc interval.
CYP3A4 Inducers: May increase the metabolism of CYP3A4 Substrates.
CYP3A4 Inhibitors: May decrease the metabolism of CYP3A4 Substrates.
Levodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Not dialysed. Dose as in normal renal function |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
In patients with hepatic impairment, isradipine clearance is reduced. Starting dose need not be changed. Adjust dose as per clinical needs.