29/07/2025
Nimodipine: (subarachnoid hemorrhage)
--> a calcium-channel antagonist with
--> a relatively selective vasodilatory effect on cerebral blood vessels,
--> has recently been approved for improvement of neurologic deficits due to spasm following subarachnoid hemorrhage.
Rx: Nimotop 30mg Tablets
Dose:
oral: 60 mg PO q4hr for 21 days; begin therapy within 96 hours of subarachnoid hemorrhage (medscape)
(total daily dose 360 mg) emc.
with or without food.
The interval between successive doses must not be less than 4 hours.
IVI: (This should continue for at least five days up to a maximum of 14 days.)
For the first two hours of treatment 1 mg of nimodipine, i.e. 5 ml Nimotop solution, (about 15 µg/kg bw/h), should be infused each hour via a central catheter. If it is well tolerated, the dose should be increased after two hours to 2 mg nimodipine, i.e. 10 ml Nimotop solution per hour (about 30 µg/kg bw/h), providing no severe decrease in blood pressure is observed.
Patients of body weight less than 70 kg or with unstable blood pressure should be started on a dose of 0.5 mg nimodipine per hour (2.5 ml of Nimotop solution), or less if necessary.
Dosage Modifications
-Renal impairment: Supplemental dose not necessary in hemodialysis or peritoneal dialysis
-Hepatic impairment: Decrease dose to 30 mg (10mL) PO q4hr; closely monitor BP and HR
Contraindications
hypersensitivity
should not be administered to patients during or within one month of a myocardial infarction or an episode of unstable angina.
The use of nimodipine in combination with rifampicin or the antiepileptic drugs, phenobarbital, phenytoin or carbamazepine is contraindicated as the efficacy of Nimotop tablets could be significantly reduced when concomitantly administered.
https://reference.medscape.com/drug/nimotop-nymalize-nimodipine-343065
https://www.medicines.org.uk/emc/product/1366/smpc
