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

Index

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

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

Dosage and brand names

Nimodipine is the generic 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 blood clot formation 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 class of drugs helps us group drugs that work similarly. Other medicines in the same category are:

Amlodipine.
Diltiazem.
Felodipine.
Lercanidipine.
Nifedipine.
Verapamil.

However, nimodipine is unique from 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 severe complication. It is usually given as an injection in an emergency, 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 surrounding the blood vessels, preventing the muscles from contracting as they usually would.

This action helps 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, known as peripheral edema. You should consult the medication information leaflet for a complete list of adverse effects.

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 severe 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 and other drugs, the way you work can interact, changing their effect on your body. In particular, it can lower your heart rate, which can be problematic when used with other medications that reduce your heart rate.

A classic example is beta-blocker medications, but several medications 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 pills:

If the capsule can not be swallowed (e.g., the patient is unconscious or in the surgery), the liquid contents can be removed from the tablet with a parenteral syringe. Still, the liquid must always be transferred to a syringe that can not accept a needle 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” to minimize administration errors. 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 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 “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.