Role of clevidipine butyrate in the treatment of acute hypertension in the critical care setting: a review

Ahmed S Awad, Michael E Goldberg

Department of Anesthesiology, Cooper University Hospital, UMDNJ-Robert Wood Johnson Medical School, Camden Campus, Camden, New Jersey, USA

Abstract: Acutely elevated blood pressure in the critical care setting is associated with a higher risk of acute end-organ damage (eg, myocardial ischemia, stroke, and renal failure) and perioperative bleeding. Urgent treatment and careful blood pressure control are crucial to prevent significant morbidity. Clevidipine butyrate (Cleviprex™) is an ultrashort-acting, third-generation intravenous calcium channel blocker. It is an arterial-selective vasodilator with no venodilatory or myocardial depressive effects. Clevidipine has an extremely short half-life of approximately 1 minute as it is rapidly metabolized by blood and tissue esterases. These metabolites are then primarily eliminated through urine and fecal pathways. The rapid onset and the short duration of action permit tighter and closer adjustment of the blood pressure than is possible with other intravenous agents.

Keywords: calcium channel blocker, antihypertensive medications, end-organ damage, hypertensive crisis, hypertensive urgency