Table 17. Anti-hypertensive drugs for acute blood pressure-lowering treatment.

Drug	Route and dosage	Onset of action	Duration of action	Side effect	Contraindication
Nicardipine	5 mg/h IVD, uptitrate 2.5 mg/h every 15-30 min, maximum 15 mg/h	5-15 min	30-40 min	Headache; reflex tachycardia	Liver failure
Labetalol	0.25-0.5 mg/kg IVB, 2-4 mg/min IVD	5-10 min	3-6 h	Bradycardia; bronchoconstriction	Second or third degree AVB; asthma; bradycardia; HFrEF
Esmolol	0.5-1 mg/kg IVB, 50-300 μg/kg/min IVD	1-2 min	10-30 min	Bradycardia	Second or third degree AVB; asthma; bradycardia; HFrEF
Glyceryl trinitrate	5 mg/d transdermally	30-60 min	12-14 h	Allergy	Concomitant PDE-5 inhibitor
Nitroglycerine	5-10 μg/min IVD, uptitrate 5 μg/min every 5 min, maximum 200 μg/min	1-5 min	3-5 min	Headache; reflex tachycardia	None
Hydralazine	10-20 mg IVB, repeat every 4-6 h, maximum 40 mg	10-20 min	12 h	Reflex tachycardia; IICP	IICP
Nitroprusside	0.3-0.5 μg/min IVD, uptitrate 0.5 μg/min every 5 min, maximum 10 μg/min	Immediate	1-2 min	Headache; reflex tachycardia; IICP	IICP

AVB, atrioventricular block; HFrEF, heart failure with reduced ejection fraction; IICP, increased intracranial pressure; IVB, intravenous bolus; IVD, intravenous drip; PDE-5, phosphodiesterase-5.