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Drug Info:

Nimodipine

Brand names: Nimotop®

Chemical formula:



Nimodipine capsules

What are nimodipine capsules?

NIMODIPINE (Nimotop®) is a calcium-channel blocker. It affects the flow of calcium in and out of certain cells in your body and relaxes blood vessels. Nimodipine is used to treat subarachnoid hemorrhage, a condition in which severe headaches and stiff neck are caused by bleeding into the space around the brain. Generic nimodipine capsules are not yet available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• heart problems, slow heart rate
• liver disease
• low blood pressure
• previous heart attack
• an unusual or allergic reaction to nimodipine, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I take this medicine?

Take nimodipine capsules by mouth. Follow the directions on the prescription label. Swallow the capsules with a drink of water. Avoid taking nimodipine with grapefruit juice or grapefruit. Take your doses at regular intervals. Do not take your medicine more often than directed. Continue to take your medicine even if you feel better. Do not stop taking except on your prescriber's advice.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose, Do not take double or extra doses.

What drug(s) may interact with nimodipine?

Do not take Nimodipine with any of the following:
 • grapefruit juice

Nimodipine may also interact with the following medications:
• antiinflammatory drugs (NSAIDs, such as ibuprofen)
• barbiturates such as phenobarbital
• bosentan
• calcium salts (intravenous)
• cimetidine
• herbal or dietary supplements such as gingko biloba, ginseng, hawthorn, ma huang (ephedra), melatonin, St. John's wort, went yeast
• imatinib, STI-571
• local anesthetics or general anesthetics
• medicines for fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole)
• medicines for high blood pressure
• medicines for HIV infection or AIDS
• medicines for prostate problems
• medicines for seizures (carbamazepine, phenobarbital, phenytoin, primidone)
• rifampin, rifapentine, or rifabutin
• some antibiotics (clarithromycin, erythromycin, telithromycin, troleandomycin)
• some medicines for heart-rhythm problems (amiodarone, diltiazem, verapamil)
• some medicines for depression or mental problems (fluoxetine, fluvoxamine, nefazodone)
• valproic acid
• water pills (diuretics)
• yohimbine
• zafirlukast
• zileuton

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking nimodipine?

Visit your prescriber or health care professional for regular checks on your progress.

Alcohol can increase the chance of getting low blood pressure. Avoid alcoholic drinks while you are taking nimodipine.

What side effects may I notice from taking nimodipine?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• difficulty breathing
• dizziness or drowsiness
• irregular or fast heartbeats (palpitations)
• lightheadedness or fainting
• slow heartbeat
• swelling of the legs or ankles
• unusual bleeding or bruising, red spots on skin
• unusual weakness or tiredness

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• flushing
• headache
• nausea
• sweating

Where can I keep my medicine?

Keep out of reach of children in a container that small children cannot open.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F); do not freeze. Protect from light. Keep foil packaged capsules in their original foil until needed. Throw away any unused medicine after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

 
 
Wikipedia: nimodipine
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Nimodipine
Systematic (IUPAC) name
2-methoxyethyl1-methylethyl2,6-dimethyl-4-(3-nitrophenyl) -1,4-dihydropyridine-3,5- dicarboxylate
Identifiers
CAS number 66085-59-4
ATC code C08CA06
PubChem 4497
DrugBank APRD00612
Chemical data
Formula C21H26N2O7 
Mol. mass 418.44 g/mol
Physical data
Melt. point 7 °C (45 °F)
Pharmacokinetic data
Bioavailability 100% (Intravenous) 13% (Oral)
Protein binding 95%
Metabolism Hepatic
Half life 8-9 hours
Excretion  ?
Therapeutic considerations
Pregnancy cat.

C: (USA)
Legal status
Routes Intravenous, Oral

Nimodipine (marketed by Bayer as Nimotop®) is a dihydropyridine calcium channel blocker originally developed for the treatment of high blood pressure. It is not frequently used for this indication, but has shown good results in preventing a major complication of subarachnoid hemorrhage (a form of cerebral hemorrhage) termed vasospasm; this is now the main use of nimodipine.

Dosage

The regular dosage is 60 mg tablets every four hours. If the patient is unable to take tablets orally, it was previously given via intravenous infusion at a rate of 1-2 mg/hour (lower dosage if the body weight is <70 kg or blood pressure is too low),[1] but since the withdrawal of the IV preparation, administration by nasogastric tube is an alternative.

Usage

Because it has some selectivity for cerebral vasculature, nimodipine's main use is in the prevention of cerebral vasospasm and resultant ischemia, a complication of subarachnoid hemorrhage (a form of cerebral bleed). Its administration begins within 4 days of a subarachnoid hemorrhage and is continued for three weeks. If blood pressure drops by over 5%, dosage is adjusted. There is still controversy regarding the use of intravenous nimodipine on a routine basis.[2][1]

A 2003 trial (Belfort et al) found nimodipine was inferior to magnesium sulfate in preventing seizures in women with severe preeclampsia.[3]

Mode of action

Nimodipine binds specifically to L-type voltage-gated calcium channels. There are numerous theories about its mechanism in preventing vasospasm, but none are conclusive.[4]

Contraindications & side-effects

Nimodipine is associated with low blood pressure, flushing and sweating, edema, nausea and other gastrointestinal problems. It is contraindicated in unstable angina or an episode of myocardial infarction more recently than one month.

While nimodipine was occasionally administered intravenously in the past, the FDA released an alert in January 2006 warning that it had received reports of the approved oral preparation being used intravenously, leading to severe complications; this was despite warnings on the box that this should not be done.[5]

References

  1. ^ a b Janjua N, Mayer SA (2003). "Cerebral vasospasm after subarachnoid hemorrhage". Current opinion in critical care 9 (2): 113–9. PMID 12657973. 
  2. ^ Allen GS, Ahn HS, Preziosi TJ, et al (1983). "Cerebral arterial spasm--a controlled trial of nimodipine in patients with subarachnoid hemorrhage". N. Engl. J. Med. 308 (11): 619–24. PMID 6338383. 
  3. ^ Belfort MA, Anthony J, Saade GR, Allen JC (2003). "A comparison of magnesium sulfate and nimodipine for the prevention of eclampsia". N. Engl. J. Med. 348 (4): 304–11. DOI:10.1056/NEJMoa021180. PMID 12540643. 
  4. ^ Rang, H. P. (2003). Pharmacology. Edinburgh: Churchill Livingstone. ISBN 0-44307-145-4. 
  5. ^ Information for Healthcare Professionals: Nimodipine (marketed as Nimotop). Retrieved on 2007-10-10.

External links

Calcium channel blockers (C08)
Dihydropyridines Amlodipine • Felodipine • Isradipine • Lacidipine • Lercanidipine • Nicardipine • Nifedipine • Nimodipine • Nisoldipine • Nitrendipine
Phenylalkylamines Verapamil
Benzothiazepines Diltiazem

This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

 
 

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Copyrights:

Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
Wikipedia. This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Nimodipine".  Read more

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