Generic
Nimodipine
2 brands available in the market
At a glance
Nimodipine is a calcium channel blocker used to prevent neurological damage after subarachnoid hemorrhage (bleeding around the brain). It dilates narrowed blood vessels in the brain to improve blood flow.
Description
Nimodipine inhibits calcium ion inflow by blocking calcium channels or select voltage-sensitive areas during depolarization, resulting in relaxation of vascular smooth muscle and myocardium. It has greater action on cerebral vessels due to its high lipophilicity.
Indications
- Prophylaxis of neurological deficit following subarachnoid haemorrhage
Therapeutic class
Calcium-channel Blockers
Pharmacological class
Dihydropyridine Calcium Channel Blocker
Pharmacology
Nimodipine blocks calcium channels to relax vascular smooth muscle and prevent cerebral vasospasm. Its high lipophilicity makes it more effective on cerebral vessels.
Mechanism of action
Dilates cerebral blood vessels to improve blood flow and prevent neurological damage.
Dosage
Adult Dose (Oral):
- 60 mg every 4 hours beginning within 4 days of hemorrhage, continued for 21 consecutive days
Hepatic Impairment: 30 mg every 4 hours
Administration
- Swallow tablet whole; do not chew, crush or break
- Take at the same time each day
- Take 1 hour before or 2 hours after meals
- Do not take antacids 2 hours before or after
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Headache
- Dizziness
- Flushing
- Heartburn
- Fast or slow heartbeat
- Upset stomach, stomach pain
- Constipation
- Depression
- Decreased blood pressure
- Edema
Precautions & warnings
- Do not abruptly discontinue
- Monitor blood pressure regularly
- Dose reduction needed in liver disease
- Caution while driving (may cause dizziness)
- Avoid alcohol
Contraindications
- Use within 1 month of MI or unstable angina
- Concurrent use with potent CYP3A4 inhibitors
Drug interactions
- Significantly reduced plasma concentration and efficacy with strong CYP3A4 inducers
- May increase serum levels and toxicity of phenytoin
- Increased plasma concentrations with cimetidine or sodium valproate
- Significant hypotension with CYP3A4 inhibitors
Food interactions
Alcohol may cause excessive drowsiness.
Use in pregnancy
Use in Pregnancy: Nimodipine may be unsafe during pregnancy; animal studies show evidence of birth defects.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Nimodipine is probably unsafe during breastfeeding; may pass into breast milk and harm the baby.
Pediatric use
No specific information for pediatric patients.
Geriatric use
Elderly may require dose adjustment.
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; dose adjustment may not be needed.
Hepatic Impairment: Caution in severe liver disease; dose adjustment may be needed.
Overdose effects
Overdose: Peripheral vasodilation, decreased blood pressure and reflex tachycardia; supportive treatment.
Storage conditions
Store below 30°C; protect from light & moisture; keep out of reach of children.
Chemical structure
Nimodipine