| name | Nimodipine |
| Classification | Calcium Channel Blocker, Dihydropyridine |
| Pharmacokinetics | Nimodipine is primarily metabolized in the liver. It has a relatively short half-life (approximately 2 hours), leading to the need for frequent dosing. The drug is largely excreted unchanged in the urine. There may be variations in individual metabolism. |
| suggested dosage | | male 25 70kg | | note | Dosage must be individualized based on the specific medical condition. Always consult with a healthcare professional for appropriate dosing. | | typical range for cerebral vasospasm | 30-60 mg every 4 hours, orally, or 2-6 mg/kg every 4 hours intravenously (rarely used). | | max dose per 24 hours | 120 mg orally per 24 hours, as a general maximum. |
|
|
| indications | Primarily used for the prevention and treatment of cerebral vasospasm after subarachnoid hemorrhage (SAH). |
| safety in pregnancy | Nimodipine is considered a category C drug in pregnancy, which means there is a theoretical risk to the fetus, or that animal reproduction studies have shown an adverse effect but adequate studies are not available in humans. Care must be taken during pregnancy, and the potential benefits must be weighed against the possible risks. |
| safety in breastfeeding | Limited data exists regarding nimodipine's excretion in breast milk. It is best to avoid breastfeeding while taking this medication, or seek advice from a healthcare provider. |
| side effects | | 1 | Headache | | 2 | Hypotension (low blood pressure) | | 3 | Flushing | | 4 | Dizziness | | 5 | Peripheral edema (swelling in the legs or feet) | | 6 | Gastrointestinal upset (nausea, vomiting, diarrhea) | | 7 | Rarely: Bradycardia (slow heart rate), heart block, and allergic reactions |
|
| alternatives | | 1 | | drug | Nicardipine | | notes | Also a calcium channel blocker, with a somewhat broader therapeutic window. |
| | 2 | | drug | Nimotop | | notes | Generic name is the same but the formulation and possible associated side effects might vary slightly based on brand. |
|
|
| contraindications | | 1 | Hypersensitivity to nimodipine or other calcium channel blockers | | 2 | Severe hypotension (low blood pressure) | | 3 | Severe heart block | | 4 | Recent myocardial infarction (heart attack) | | 5 | Uncontrolled congestive heart failure |
|
| interactions | | 1 | Other calcium channel blockers | | 2 | Drugs that lower blood pressure (antihypertensives) | | 3 | CYP3A4 inhibitors (can increase nimodipine levels) | | 4 | CYP3A4 inducers (can decrease nimodipine levels) |
|
| warnings and precautions | | 1 | Monitor blood pressure closely, especially during the initial stages of treatment and with any changes in dosage. | | 2 | Caution in patients with pre-existing cardiovascular conditions (e.g., heart failure, hypertension). | | 3 | Administer with caution, if at all, in patients with hepatic impairment due to possible accumulation of the medication in the body. | | 4 | Not for routine use for hypertension or other conditions |
|
| additional information | | administration | Oral administration only; intravenous route is reserved for specific situations. | | monitoring | Regular blood pressure monitoring is critical. |
|
