clevidipina

Clevidipine is an intravenous dihydropyridine calcium channel blocker used for rapid, controlled reduction of blood pressure in adults. It is particularly employed during perioperative care and in hypertensive emergencies where quick BP lowering is required.

Mechanism of action is arterial-selective vasodilation achieved by inhibiting L-type calcium channels in vascular smooth muscle. This lowers systemic vascular resistance with little impact on venous capacitance or cardiac contractility, though reflex tachycardia can occur. The drug is formulated as a lipid emulsion, which contributes to its ultra-short duration of action.

Pharmacokinetics and administration are characterized by rapid metabolism. Clevidipine is hydrolyzed by nonspecific plasma and tissue esterases to inactive metabolites, and its effects dissipate quickly after the infusion is stopped. Because of this rapid breakdown, hepatic or renal impairment generally does not necessitate dose adjustment, and onset occurs within minutes while offset occurs within approximately 5 to 15 minutes.

Indications include the acute management of severe hypertension when a rapid, controlled reduction is necessary, most commonly in the perioperative setting or during hypertensive crises in adults. It is not intended for long-term blood pressure control.

Contraindications include hypersensitivity to clevidipine or to components of the emulsion, such as soybeans or egg products. Because it is a lipid emulsion, use with caution in disorders of lipid metabolism and in patients with significant lipid-related concerns. Potential adverse effects are headache, nausea, vomiting, flushing, edema, tachycardia, palpitations, and hypotension, with careful hemodynamic monitoring required during administration.