What it's for (Indications)
- Nimodipine is used in the prevention of ischemic neurological deficits and to reduce the severity of neurological deficits caused by cerebral vasospasm following subarachnoid hemorrhage (SAH).
Dosage Information
| Type | Guideline |
|---|---|
| Standard | The recommended oral dose is 60 mg (two 30 mg capsules) every 4 hours for 21 consecutive days. Therapy should commence as soon as possible, ideally within 96 hours of the onset of subarachnoid hemorrhage. Capsules should be swallowed whole with a little liquid, preferably not less than one hour before or two hours after meals. Grapefruit juice must be avoided. If the patient cannot swallow the capsule, e.g., during surgery or if unconscious, the contents can be extracted from the capsule and administered via a nasogastric tube; specific instructions for piercing the capsule and flushing the tube should be followed. |
Safety & Warnings
Common Side Effects
- Commonly reported adverse effects include decreased blood pressure (hypotension), headache, flushing, gastrointestinal symptoms (GI upset, diarrhea, nausea), and changes in heart rate (including EKG abnormalities).
- Other reported side effects include transient rise in liver enzymes (abnormal liver function test), edema, rash, dyspnea, and allergic reactions.
Serious Warnings
- Black Box Warning: DO NOT ADMINISTER NIMODIPINE INTRAVENOUSLY OR BY OTHER PARENTERAL ROUTES. DEATHS AND SERIOUS, LIFE THREATENING ADVERSE EVENTS HAVE OCCURRED WHEN THE CONTENTS OF NIMODIPINE CAPSULES HAVE BEEN INJECTED PARENTERALLY.
- Pregnancy risk cannot be ruled out; pregnant females should consult their healthcare provider.
- Use with caution in patients with cerebral edema, raised intracranial pressure, renal impairment, cirrhosis, and pre-existing hypotension.
- Blood pressure should be monitored regularly.
- Avoid consumption of grapefruit juice due to potential drug interactions.
- There is a critical warning regarding the route of administration; nimodipine capsules or their contents must not be administered intravenously or by other parenteral routes.
How it Works (Mechanism of Action)
Nimodipine is a calcium channel blocker. The contractile processes of smooth muscle cells are dependent upon calcium ions, which enter these cells during depolarization. Nimodipine inhibits calcium ion transfer into these cells, thereby inhibiting contractions of vascular smooth muscle. In animal experiments, nimodipine has a greater effect on cerebral arteries, possibly due to its high lipophilicity allowing it to cross the blood-brain barrier. The precise mechanism of action in humans for its effect on neurological deficits following SAH is unknown.
Commercial Brands (Alternatives)
No other brands found for this formula.