constantly [18:99.5%. 1 Elimination Metabolism Rapidly metabolized via hydrolysis, principally by esterases in the blood and extravascular tissues, to form an inactive carboxylic acid metabolite and formaldehyde. 1 2 3 4 5 6 8 9 10 Elimination Route Excreted in urine (63 74%) and in feces (7 22%). 1 6 7 10 Half-life Multiphasic; initial half-life is about 1 minute (accounts for 85 90% of elimination) and terminal half-life is about 15 minutes. 1 2 3 4 7 8 9 10 Special Populations Elimination unlikely to be affected by hepatic or renal dysfunction. 1 2 3 4 5 6 8 9 10 Stability Storage Parenteral Injectable Emulsion 2 8 C; protect form light by storing in carton. 1 Do not freeze. 1 Vials may be removed from refrigerator and stored at 25 C for 2 months; however, may not be returned to refrigerator. 1 Compatibility For information on systemic interactions resulting from concomitant use, see Interactions. Parenteral Solution Compatibility Compatible Amino acid 10% 1 Dextrose 5% in Ringer s injection, lactated 1 Dextrose 5% in sodium chloride 0.9% 1 Dextrose 5% in water 1 Ringer s injection, lactated Sodium chloride 0.9% 1 Actions Inhibits transmembrane influx of calcium ions during depolarization in arterial smooth muscle. 1 Reduces mean arterial BP by decreasing systemic vascular resistance, but does not appear to reduce cardiac filling pressure (i.e., preload), confirming lack of effects on venous capacitance vessels. 1 9 Advice to Patients Importance of advising patients with underlying hypertension that they require continued monitoring of their condition and importance of taking oral antihypertensive drugs as directed. 1 Importance of contacting a clinician immediately if symptoms of a new hypertensive emergency occur (e.g., neurologic symptoms, visual changes, evidence of CHF). 1 Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. 1 Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses. 1 Importance of informing patients of other important precautionary information. 1 (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Clevidipine Butyrate Routes Dosage Forms Strengths Brand Names Manufacturer Parenteral Injectable emulsion, for IV use 0.5 mg/mL Cleviprex Medicines Company AHFS DI Essentials. Copyright 2017, Selected Revisions January 31, 2012. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. References 1. The Medicines Company. Cleviprex (clevidipine butyrate) injectable emulsion for IV administration prescribing information. Parsippany, NJ; 2008 Aug. 2. Levy JH, Mancao MY, Gitter R et al. Clevidipine effectively and rapidly controls blood pressure preoperatively in cardiac surgery patients: the results of the randomized, placebo-controlled efficacy study of clevidipine assessing its preoperative antihypertensive effect in cardiac surgery-1. Anesth Analg . 2007; 105:918-25, table of contents. [PubMed 17898366] 3. Singla N, Warltier DC, Gandhi SD et al. Treatment of acute postoperative hypertension in cardiac surgery patients: an efficacy study of clevidipine assessing its postoperative antihypertensive effect in cardiac surgery-2 (ESCAPE-2), a randomized, double-blind, placebo-controlled trial. Anesth Analg . 2008; 107:59-67. [PubMed 18635468] 4. Pollack CV, Varon J, Garrison NA et al. Clevidipine, an Intravenous Dihydropyridine Calcium Channel Blocker, Is Safe and Effective for the Treatment of Patients With Acute Severe Hypertension. Ann Emerg Med . 2008; :. [PubMed 18534716] 5. Ericsson H, Bredberg U, Eriksson U et al. Pharmacokinetics and arteriovenous differences in clevidipine concentration following a short- and a long-term intravenous infusion in healthy volunteers. Anesthesiology . 2000; 92:993-1001. [PubMed 10754618] 6. Ericsson H, Fakt C, Höglund L et al. Pharmacokinetics and pharmacodynamics of clevidipine in healthy volunteers after intravenous infusion. Eur J Clin Pharmacol . 1999; 55:61-7. [PubMed 10206087] 7. . Clevidipine. Drugs R D . 2002; 3:190-2. [PubMed 12099165] 8. Nordlander M, Sjöquist PO, Ericsson H et al. Pharmacodynamic, pharmacokinetic and clinical effects of clevidipine, an ultrashort-acting calcium antagonist for rapid blood pressure control. Cardiovasc Drug Rev . 2004; 22:227-50. [PubMed 15492770] 9. Aronson S, Dyke CM, Stierer KA et al. The ECLIPSE trials: comparative studies of clevidipine to nitroglycerin, sodium nitroprusside, and nicardipine for acute hypertension treatment in cardiac surgery patients. Anesth Analg . 2008; 107:1110-21. [PubMed 18806012] 10. . Clevidipine (Cleviprex) for IV treatment of severe hypertension. Med Lett Drugs Ther . 2008; 50:73-4. [PubMed 18800023] 11. The Medicines Company, Parsippany, NJ: Personal communication. 12. Smith WB, Marbury TC, Komjathy SF et al. The pharmacokinetics and pharmacodynamics of clevidipine after prolonged continuous infusion in patients with essential hypertension. In: American College of Clinical Pharmacy. 2007 Annual Meeting Guide and Abstracts; October 14 17, 2007; Denver, CO. Abstract No. 221. Available at . Accessed 2009 Jul 17. Next Interactions Print this page Add to My Med List More about Cleviprex (clevidipine) Side Effects During Pregnancy Dosage Information Drug Interactions Support Group Pricing & Coupons En Español 0 Reviews Add your own review/rating Drug class: calcium channel blocking agents Consumer resources Cleviprex Cleviprex (Advanced Reading) Professional resources Cleviprex (FDA) Clevidipine Butyrate (AHFS Monograph) Related treatment guides High Blood Pressure Hypertensive Emergency] FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Manufacturer The Medicines Company Drug Class Calcium channel blocking agents Related Drugs Hypertensive Emergency hydralazine , enalapril , nifedipine , labetalol , captopril , Vasotec , Apresoline , methyldopa , Capoten , Normodyne , Trandate , nitroprusside , More... 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