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Comparative Efficacy and Safety of Clevidipine Versus Nicardipine in Hypertensive Emergencies: A Systematic Review

Tahir Ullah1, Hamed Khan1, Anfal Khan1

  • 1Saidu Medical College, Swat, Pakistan.

Clinical Cardiology
|July 16, 2026
PubMed

Insights

Clevidipine and nicardipine are equally effective and safe for hypertensive emergencies. While clevidipine showed faster blood pressure control in some groups and lower infusion volumes, overall clinical superiority was not proven.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Pharmacology

Background:

  • Hypertensive emergencies necessitate rapid blood pressure reduction to avert target-organ damage.
  • Intravenous clevidipine and nicardipine are common dihydropyridine calcium channel blockers, but their comparative effectiveness is unclear.
  • This study systematically reviewed and meta-analyzed clinical outcomes of clevidipine versus nicardipine.

Purpose of the Study:

  • To compare the efficacy and safety of clevidipine and nicardipine in managing hypertensive emergencies.
  • To evaluate key clinical outcomes including time to target systolic blood pressure (SBP) and length of stay.

Main Methods:

  • Systematic review and meta-analysis of comparative studies.
  • Searched PubMed, Cochrane Library, and ClinicalTrials.gov up to July 3, 2026.
  • Included 9 studies with 1378 adult patients requiring acute SBP control.

Main Results:

  • No significant differences found between clevidipine and nicardipine for primary and secondary outcomes.
  • Clevidipine demonstrated faster SBP target attainment in stroke/neurocritical care and general hypertensive crisis subgroups.
  • Clevidipine was associated with significantly lower infusion drug volume.

Conclusions:

  • Clevidipine and nicardipine exhibit comparable efficacy and safety profiles in hypertensive emergencies.
  • Clevidipine offers potential advantages in infusion volume and speed of SBP control in specific populations.
  • Larger randomized trials are recommended to validate these findings.
Abstract

Keywords:
clevidipinehypertensive emergencymeta‐analysisnicardipinesystematic review

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