The effects of nicardipine on cerebrospinal fluid pressure in humans

The effects of nicardipine hydrochloride, a calcium channel blocker, upon cerebrospinal fluid pressure (CSFP) were investigated in 47 patients without intracranial pathology who were assigned to one of three groups: group 1 (n = 17), who received 0.01 mg/kg nicardipine, group 2 (n = 17), who received 0.02 mg/kg, and group 3 (n = 13), who received 0.03 mg/kg. A spinal needle was inserted into the subarachnoid space to permit continuous measurement of CSFP. Nicardipine produced statistically significant increases in CSFP: from a mean of 7.6 to 11.6 mm Hg in group 1, 7.2 to 12.2 mm Hg in group 2, and 7.4 to 13.8 mm Hg in group 3 (P less than 0.001 in each group). CSFP after nicardipine attained its maximum in 1-2 min, the gradually returned to control levels. Changes in CSFP were always associated with statistically significant decreases in arterial blood pressure and cerebral perfusion pressure, whereas the heart rate showed significant increases. Nicardipine may increase CSFP to undesirable levels in patients with intracranial hypertension.