Nimodipine
Calcium Antagonist · Calcium antagonist
Indications
Infusion: Treatment of neurological deficits following subarachnoid haemorrhage. Tab: Prevention of ischaemic neurological deficits following subarachnoid haemorrhage.
Dosage
Adults: ORAL: 2 tab four hrly starting within 4 days of subarachnoid haemorrhage and continue for 21 days. INFUSION: 1 mg/hr by IV infusion for first 2 hr, then 2 mg/hr for minimum 5 days, max 14 days. Patients weighing under 70 kg or with unstable BP, start on 0.5 mg/hr. If surgical intervention during treatment, continue for at least 5 days after surgery. Max total duration of nimodipine use is 21 days. Children: Not recommended.
Administration
Via drip tubing in D5W or NS or Compound sodium lactate. Not to be added to infusion container, administer via an infusion pump through a Y-piece into a central catheter. Compatibility: Incompatible with polyvinyl chloride giving sets or containers. Stability: Nimodipine infusion solution must not be mixed with other drugs. It is advisable to continue administration of nimodipine infusion solution during anesthesia, surgery and angiography. Protect infusion from light.
Adverse Effects
Hypotension, flushing, headache, changes in heart rate, GI upset. Transient rise in liver enzymes may occur with infusion. Allergic reactions.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: During or within one month of MI or an episode of unstable angina. Precautions: Cerebral oedema, raised intracranial pressure, renal impairment, cirrhosis, hypotension (Infusion only). Monitor BP. Nimotop infusion is incompatible with PVC.
Interactions
Beta-blockers, other calcium antagonists, anticonvulsants, cimetidine, antihypertensives, valproic acid, quinupristin/dalfopristin, zidovudine, CYP3A4 inducers ( rifampicin, phenobarbital, phenytoin, carbamazepine) or inhibitors ( macrolides, azole antifungals, protease inhibitors, nefazodone), fluoxetine, nortriptyline, grapefruit juice. Inf: Nephrotoxic drugs, IV B- blockers.
Advice to Patient
Take with or without meals. Do not chew or crush tablets, swallow whole. Contact prescriber if there is chest pain, palpitations, slow heartbeat or difficulty in breathing. Avoid grapefruit juice during therapy. Change position slowly when climbing stairs and from lying or sitting to standing.
Pharmacokinetics
Metabolism: Extensively hepatic, undergoes first-pass metabolism. Bioavailability: Cap: 13%. Tab: 16%. Half-life elimination: 1-2 hrs. Time to peak, serum: Approx. 1 hr. Excretion: Urine. Faeces.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.