Clevidipine: a novel ultra-short-acting calcium antagonist

Hypertension is the most common cardiovascular condition in the United States. It can lead to end organ damage and increased mortality risk if it is not properly controlled. In most situations where blood pressure has to be brought down quickly, an intravenous agent with a quick onset of action is often used. Clevidipine is the first third-generation IV dihydropyridine calcium channel blocker that has a high degree of vascular selectivity and an ultra-fast onset and offset of blood pressure lowering effect. In various clinical trials, clevidipine has shown to be safe and effective in controlling acute blood pressure elevations in patients with hypertensive emergencies, preoperative hypertension, and postoperative hypertension. The most common adverse events noted are atrial fibrillation, nausea, headache, and acute renal failure. Overall, clevidipine is a useful addition to available intravenous agents in reducing blood pressure during acute situations. The acceptance of this agent to hospital formularies may ultimately depend on its perceived ease of administration, clinically relevant benefits over other available agents, and acquisition costs.