Authors' objectives: Identify and summarize evidence on intravenous clevidipine for blood pressure management in patients with acute intracerebral hemorrhage.

Authors' results and conclusions: EVIDENCE SUMMARY ▪Clevidipine is an ultrashort-acting IV calcium channel blocker used to treat high blood pressure in patients with acute intracerebral hemorrhage (ICH). ▪In clinical studies of patients with ICH , clevidipine is most often compared to nicardipine. The evidence base for this comparison in this patient group comprises 5 cohort or pre-post studies, all of which are at increased risk of bias. Confounding is also a problem with this evidence base because drugs were selected at the discretion of the treating physician, and key characteristics of patients in the clevidipine and nicardipine groups differed in some studies. In addition, studies combined patients with different types of ICH, so the applicability of results to specific patient groups is uncertain. ▪Patient-oriented outcomes such as mortality, rebleeding, and length of stay do not differ significantly between clevidipine and nicardipine. The evidence for most of these conclusions is of very low strength. Intermediate outcomes relating to blood pressure do not appear to differ significantly. The evidence for these conclusions is also of very low strength. ▪Published clinical practice guidelines discuss blood pressure targets and the effect of blood pressure on ICH outcomes and mention clevidipine among drugs that are used for managing blood pressure, but they do not make any recommendations for or against clevidipine versus other drugs. The PennPathway for ICH calls for intravenous nicardipine and labetalol for acute blood pressure control. ▪The evidence base will remain weak until randomized trials are completed and they report results stratified by patient subgroups instead of combining all types of cerebrovascular patients.

Project Status: Completed

Year Published: 2026

URL for published report: https://www.med.upenn.edu/CEP/external-request-form.html

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: United States

Organisation Name: Penn Medicine Center for Evidence-based Practice

Contact Address: Penn Medicine Center for Evidence-based Practice, University of Pennsylvania Health System, 3600 Civic Center Blvd, 3rd Floor West, Philadelphia PA 19104

Contact Name: Nikhil Mull

Contact Email: cep@pennmedicine.upenn.edu

Copyright: <p>Center for Evidence-based Practice (CEP)</p>