Nimodipine: Indications, Administration, Dosage, Side Effects, Precautions and Interactions

It is a type of medication called a calcium channel blocker, which works by blocking the passage of calcium to the cells of the body.

It is usually used to prevent or treat ischemic neurological deficits after a subarachnoid hemorrhage .

Dosage and brand names

Nimodipine is the generic name, the name of the actual drug component in your medicine, which you may also know by its brand name Nimotop. It is available as a tablet with a dose of 30 mg.

Alternatively, it is also available for emergency use to stop the formation of a blood clot as an injection with 0.2 mg / ml of nimodipine.

What kind of drug is it?

Nimodipine is a type of medication called calcium channel blocker dihydropyridine. This is a class of medications that helps us group drugs that work similarly. Other drugs in the same class are:

However, nimodipine is unique to other medications in this class, since it is usually used after a subarachnoid hemorrhage to prevent complications, instead of controlling hypertension .

Indications

There is a high risk of complications if you have recently had an aneurysmal subarachnoid hemorrhage. This is usually due to the formation of a blood clot that causes neurological damage.

Nimodipine is used to prevent vasospasm after this event, which reduces the risk of this serious complication. In an emergency situation, it is usually given as an injection, but it is also available as an oral tablet.

How does Nimodipino work?

It works by blocking the passage of calcium to the smooth muscles that surround the blood vessels, which prevents the muscles from contracting as they normally would.

This action is useful to prevent ischemia or the formation of a transfer clot. Usually, spasms of the blood vessels can sometimes cause a blood clot, but nimodipine stops the spasms and reduces the risk of ischemia.

Side effects

Low blood pressure is a common side effect of nimodipine, which can cause symptoms such as:

  • Headache.
  • Fatigue.
  • Dizziness.
  • Low heart rate

Sometimes it can also cause fluid retention in the body, causing the ankles to swell, which is known as peripheral edema. For a complete list of adverse effects, you should consult the medication information leaflet.

Precautions

It is not always the best medication option and there are several cases in which it should not be used. For example, the way it works leads to lower blood pressure, so it should not be used if you already have hypotension .

Cerebral edema is a serious complication that can affect some people when taking nimodipine, so the signs for this should be controlled during treatment.

Cerebral edema is a serious complication that can affect some people when taking nimodipine, so the signs for this should be controlled during treatment.

 Drug interactions

When you take nimodipine along with other drugs, the way you work can interact, changing its effect on your body. In particular, it can lower your heart rate, which can be a problem when used with other medications that reduce your heart rate.

A classic example of this is beta-blocker medications, but there are several medications that can have a similar effect.

Pregnancy and lactation

You should avoid nimodipine if you are pregnant or plan to get pregnant soon, as it can cause maternal hypotension and cause an insufficient supply of oxygen to your baby. There is no evidence of its safe use during pregnancy or breastfeeding, so it is generally not recommended.

Administration

For oral administration only.

The contents of the nimodipine capsule and the oral solution should NOT be administered intravenously or by any parenteral route. If given intravenously or parenterally, the medication can cause serious adverse effects, including cardiovascular collapse and death.

Oral administration:

Administer preferably at least 1 hour before or 2 hours after meals; Food reduces bioavailability by approximately 38%.

Avoid taking it with grapefruit or grapefruit juice.

Oral solid formulations:

Preparation of the oral solution of capsules for patients incapable of swallowing capsules:

If the capsule can not be swallowed (eg, Patient unconscious or at the time of surgery), the liquid contents can be removed from the capsule with a parenteral syringe, but the liquid must always be transferred to a syringe that can not accept a needle and is designed for oral administration or through a nasogastric tube or a gastric tube.

To minimize administration errors, the syringe should be labeled “Not for IV use”. The content can then be emptied into the patient’s nasogastric or gastric tube.

Rinse the feeding tube with 30 ml of 0.9% normal saline (NS) to ensure full dose delivery. Never administer the oral dosage form intravenously or by other parenteral routes.

To improve patient safety and minimize the potential for parenteral administration, the Institute for the Practice of Safe Medicines recommends that doses to be administered through nasogastric or gastric tubes be prepared by the pharmacy in oral amber syringes and dispensed in protected bags. with light and labeled.

Oral liquid formulations:

Administer using the oral syringe supplied with the label “ORAL USE ONLY”.
For each dose, refill the syringe with 20 ml of 0.9% saline and wash the remaining contents of the nasogastric or gastric tube in the stomach.

Storage

Nimotop:
  • Protect from freezing.
  • Protect from light.
  • Store between 68 to 77 degrees F, excursions allowed 59 to 86 degrees F.
  • Store in the original package until the moment of use.
Nymalize:
  • Protect from light.
  • Store between 68 to 77 degrees F, excursions allowed 59 to 86 degrees F.