Nimodipine - drug information

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Nimodipine - drug information
Nimodipine - drug information

Nimodipine is a drug to prevent and treat brain damage due to lack of blood supply during subarachnoid hemorrhage. This drug is available in tablet and infusion form

A subarachnoid hemorrhage occurs when a blood vessel in the protective lining of the brain bursts. The body will automatically respond to this bleeding by constricting the blood vessels in the area of bleeding, so that blood flow slows down. However, this response can actually cause further brain damage.

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Nimodipine works by dilating constricted cerebral blood vessels near the area of bleeding or preventing them from widening. That way, blood can flow more smoothly and the risk of brain damage can be prevented.

Nimodipine Trademark: Ceremax, Nimodipine, Nimodipine G, Nimodipine 0.02% Infusion, Nimotop.

What is Nimodipine

Class Prescription drugs
Category Calcium-channel blockers or calcium antagonists
Benefits Treat and prevent brain damage due to subarachnoid hemorrhage.
Used by Adult
Nimodipine for pregnant and lactating women Category C: Animal studies have shown adverse effects on the fetus, but there are no controlled studies in pregnant women.

Drugs should only be used if the expected benefit outweighs the risk to the fetus.

Nimodipine can be absorbed into breast milk so it should not be used by mothers who are breastfeeding.

Medicine form Tablets and IV fluids

Warning Before Using Nimodipine

Nimodipine is a prescription drug that should not be used carelessly. There are several things that need to be considered before undergoing treatment with nimodipine, namely:

  • Tell your doctor about your allergy history. Nimodipine should not be given to patients who are allergic to this drug or to other classes of calcium antagonist drugs, such as amlodipine.
  • Tell your doctor if you have or have ever had low blood pressure, cirrhosis or other liver disease, porphyria, heart failure, and kidney disease.
  • Tell your doctor if you have recently had chest pain, heart attack, or head injury.
  • Do not drive a vehicle, operate heavy machinery, or perform activities that require alertness after taking nimodipine, as this drug can cause dizziness.
  • Avoid consuming grapefruit and alcohol while taking nimodipine, as this will increase the risk of hypotension.
  • Tell your doctor if you are pregnant, breastfeeding, or planning a pregnancy.
  • Tell your doctor if you are taking any other medications, including supplements and herbal products.
  • Notify your doctor immediately if you experience an allergic drug reaction, serious side effect, or overdose after using nimodipine.

Dosage and Instructions for Use of Nimodipine

The dose and duration of treatment will be determined by the doctor according to the form of the drug, as well as the patient's condition and body response to treatment. Under certain conditions, the doctor will determine the dose of nimodipine according to the patient's body weight.

The following is the distribution of nimodipine doses for adults based on the form of the drug and its intended use:

Nimodipine tablets

Aim: Prevent brain damage after subarachnoid hemorrhage

  • The dose is 60 mg, taken every 4 hours, for 21 days. Treatment should be started as soon as possible when bleeding occurs or within 96 hours of bleeding.

Nimodipine infusion

Aim: Treating brain damage due to subarachnoid hemorrhage

  • Initial dose 1 mg per hour, for 2 hours. The dose may be increased to 2 mg per hour if the patient's blood pressure is stable. For patients weighing <70 kg or patients whose blood pressure is unstable, the initial dose is 0.5 mg per hour.

The duration of treatment with nimodipine infusion can last 5–14 days. The total duration of treatment should not exceed 21 days if the patient is already taking nimodipine tablets.

How to Use Nimodipine Correctly

Nimodipine in the form of intravenous fluids will be given directly by a doctor or medical personnel under the supervision of a doctor. This drug will go into a vein (intravenous) through an IV.

For nimodipine tablets, follow the doctor's recommendations and read the instructions for use listed on the drug packaging before using nimodipine. Do not reduce or increase your dose, or use this medicine for more than the time recommended by your doctor.

Nimodipine tablets can be taken with or without food. Swallow the tablet whole with a glass of water. Do not chew, split, or crush the tablet. Do not lie down immediately after taking this medicine. Wait at least 10 minutes before lying down.

It is recommended to take nimodipine tablets regularly at the same time every day, in order to maximize the effect of treatment. If you forget to take this medicine, take it immediately if the interval between the next consumption schedule is not too close. If it's close, ignore it and don't double the dose.

During treatment, patients need to monitor heart rate and blood pressure regularly to monitor response to therapy and be aware of side effects. Do not stop treatment without consulting your doctor first.

Store nimodipine tablets in a closed container in a cool room. Do not store it in a humid place or in direct sunlight. Keep this medicine out of reach of children.

Interaction of Nimodipine with Other Drugs

The use of nimodipine with certain drugs can cause drug interactions, such as:

  • Increased risk of severe hypotension when used with beta-blocking drugs, such as bisoprolol and atenolol
  • Increased risk of severe hypotension with clarithromycin, ritonavir, ketoconazole, alprazolam, or nefazodone
  • Increased blood levels of nimodipine when used with cimetidine or sodium valporate
  • Decreased levels and effectiveness of nimodipine when used with rifampicin, phenobarbital, carbamazepine, and phenytoin
  • Increased risk of hypertension if used with NSAIDs, such as mefenamic acid or ibuprofen

If taken with grapefruit, nimodipine levels in the blood can increase and cause side effects. Meanwhile, the use of herbal products containing St. John's wort may decrease nimodipine levels and effectiveness.

Side Effects and Dangers of Nimodipine

Side effects that may occur after using nimodipine are:

  • Nausea
  • stomach ache
  • Headache
  • Redness and warmth on the skin (flushing)
  • Muscle pain
  • Sweating a lot

Check with your doctor if the side effects above don't go away or get worse. See a doctor immediately if you experience an allergic reaction to a drug or serious side effect, such as:

  • Slow, too fast, or irregular heartbeat
  • Swelling in the legs or feet
  • chest pain
  • Shortness of breath
  • Blurred vision
  • Can't defecate for more than 3 days
  • Fainted