transitioning patients off CLEVIPREX® (clevidipine)

Cleviprex vials

Steps to transition to oral antihypertensive therapy

If oral therapy is initiated, consider the following¹:
- Oral therapy will have a lag onset time
- The half-life of CLEVIPREX is ~1 minute; in most patients, full recovery of BP occurs 5 to 15 minutes after discontinuation
Discontinue CLEVIPREX or down-titrate as oral therapy takes effect¹
- In a study in acute severe hypertension, oral therapy was started before discontinuation or down-titration of CLEVIPREX²
Continue BP monitoring until desired BP is achieved¹

Considerations for follow-up, monitoring, or when no oral antihypertensive therapy has been initiated¹

In most patients, full recovery of BP occurs 5 to 15 minutes after CLEVIPREX infusion is stopped
Monitor for rebound hypertension for at least 8 hours after CLEVIPREX infusion is stopped
Follow-up adjustments in BP control may be needed in patients who receive prolonged CLEVIPREX infusions and are not transitioned to other antihypertensive therapies

The CLEVIPREX Dosing and Administration Guide

Use this guide as a quick reference to help with CLEVIPREX dosing and administration.

CLEVIPREX Dosing and Administration Guide

Download CLEVIPREX® (clevidipine) Dosing & Administration Guide PDF

Other dosing guidelines

There are additional storage, handling, and administration guidelines to consider when using CLEVIPREX.

See Additional CLEVIPREX Dosing Information

Important Safety Information

CLEVIPREX^® (clevidipine) Injectable Emulsion is contraindicated in patients with:

Allergies to soybeans, soy products, eggs, or egg products;
Defective lipid metabolism seen in conditions such as pathologic hyperlipemia, lipoid nephrosis, or acute pancreatitis if it is accompanied by hyperlipidemia; and
Severe aortic stenosis.

CLEVIPREX^® is intended for intravenous use. Use aseptic technique and discard any unused product within 12 hours of stopper puncture.

Hypotension and reflex tachycardia are potential consequences of rapid upward titration of CLEVIPREX^®. If either occurs, decrease the dose of CLEVIPREX^®. There is limited experience with short-duration therapy with beta-blockers as a treatment for CLEVIPREX^®-induced tachycardia. Beta-blocker use for this purpose is not recommended.

CLEVIPREX^® contains approximately 0.2 g of lipid per mL (2.0 kcal). Lipid intake restrictions may be necessary for patients with significant disorders of lipid metabolism.

Dihydropyridine calcium channel blockers can produce negative inotropic effects and exacerbate heart failure. Monitor heart failure patients carefully.

CLEVIPREX^® is not a beta-blocker, does not reduce heart rate, and gives no protection against the effects of abrupt beta-blocker withdrawal. Beta-blockers should be withdrawn only after a gradual reduction in dose.

Patients who receive prolonged CLEVIPREX^® infusions and are not transitioned to other antihypertensive therapies should be monitored for the possibility of rebound hypertension for at least 8 hours after the infusion is stopped.

There is no information to guide use of CLEVIPREX^® in treating hypertension associated with pheochromocytoma.

Most common adverse reactions for CLEVIPREX^® (>2%) are headache, nausea, and vomiting.

Indication

CLEVIPREX^® (clevidipine) is a dihydropyridine calcium channel blocker indicated for the reduction of blood pressure (BP) when oral therapy is not feasible or not desirable.

Please see Full Prescribing Information.

References: 1. CLEVIPREX^® (clevidipine) Prescribing Information. 2021. 2. Pollack CV, Varon J, Garrison NA, Ebrahimi R, Dunbar L, Peacock WF. Clevidipine, an intravenous dihydropyridine calcium channel blocker, is safe and effective for the treatment of patients with acute severe hypertension. Ann Emerg Med. 2009;53(3):329-338.