Nimodipine
Nimodipine is a dihydropyridine calcium channel blocker used for the prevention and treatment of ischemic deficits that may result from a subarachnoid hemorrhage. It is used to reduce neurological deficits that can occur after a subarachnoid hemorrhage (SAH; an often-fatal form of stroke caused by bleeding in the brain), which involves a burst aneurysm. It is not used to treat primary strokes or SAH due to trauma or other causes.
Uses For Nimodipine
Nimodipine is used to reduce neurological deficits that may occur after a subarachnoid hemorrhage. It works by inhibiting the entry of calcium ions into vascular smooth muscle cells, inducing vasodilation and reducing vasospasm. By preventing the onset of vasospasm, it can reduce the risk of stroke and potentially life-threatening brain damage.
| Brand Name | Nimodipine |
|---|---|
| Type | |
| Weight | |
| Generic | Nimodipine |
| Manufacturer | |
| Available in | English বাংলা |
Mechanism of Action
Nimodipine works by inhibiting the entry of calcium ions into vascular smooth muscle cells in the brain. Calcium ions are important for cell signaling and transport, but they can also cause spasms in the small arteries of the brain. By blocking calcium ions, nimodipine reduces the risk of spasms and helps to maintain normal blood flow in the brain.
How Long Does it Take to Work?
Nimodipine typically begins to take effect within 1–2 hours after it is administered. It is generally recommended to keep taking the medication for at least three months to prevent recurrence of symptoms and maintain stable blood flow in the brain.
Absorption
Nimodipine is rapidly absorbed after oral administration, reaching peak concentrations within 1–2 hours after dosing. The drug is highly bound (>90%) to plasma protein and is widely distributed in the body, with a volume of distribution of approximately 2 L/kg.
Route of Elimination
Nimodipine is primarily eliminated via the kidneys. It has an elimination half-life of approximately 3 hours and is excreted unchanged in the urine.
Dosage
Adult: Initial dose is 60 mg in every four hours interval for 21 consecutive days, preferably not less than one hour before or two hours after meals. Oral Nimodipine therapy should be commence within 96 hours of the subarachnoid hemorrhage.Use in Pediatric Patients: While there is no specific information on use of this medication in pediatric patients.
The recommended dose for adults is 60 mg orally administered every four hours for a total of 21 doses per day. For pediatric patients, the total daily dose should not exceed 3.6 mg/kg per day. Nimodipine should not be administered intravenously. It is advised to take nimodipine with food to help reduce irritation of the stomach.
Administration
Nimodipine is oral medication to be taken every four hours with food. It may be taken with or without food. For pediatric patients, nimodipine should not be administered intravenously.
Side Effects
Common side effects of nimodipine include dizziness, headache, nausea, weakness, rash, and flushing. Other rare side effects may include hypotension (low blood pressure), heart block, and bradycardia (slow heart rate). Long-term use of nimodipine may increase the risk of developing cancer.
Toxicity
The LD50 of nimodipine is 550 mg/kg in rats. In humans, the drug has a low toxicity, even at high doses. At doses above 300 mg/day, nimodipine may cause drowsiness, dizziness, and weakness.
Precaution
Nimodipine should be used with caution in patients with renal impairment, as it is eliminated primarily via the kidneys. Nimodipine should also be used with caution in patients with heart block due to the risk of severe bradycardia. Patients may be more prone to dizziness while taking nimodipine, and should be encouraged to remain seated or lie down when symptoms occur.
Interaction
Nimodipine may interact with other medications, such as antihypertensives, anticonvulsants, and calcium channel blockers. It may also interact with herbs and supplements, such as St. John’s Wort, garlic, and ginseng. It is important to inform your doctor of any medications or supplements you are taking.
Disease Interactions
Nimodipine should not be used in patients with hypotension or heart block due to the risk of further reduction in blood pressure or bradycardia. Other diseases that may be contraindicated in patients taking nimodipine include heart failure, hypertension, and liver or kidney disease.
Drug Interactions
Nimodipine may interact with medications including antihypertensives, anticonvulsants, and calcium channel blockers. It is important to inform your doctor of any medications you are taking.
Food Interactions
Nimodipine may interact with certain foods, including dairy, caffeine, and alcohol. It is important to inform your doctor of any dietary changes that may affect your treatment.
Pregnancy Use
Nimodipine should be used with caution during pregnancy as it may cause adverse effects in the fetus. It is not recommended for women who are breastfeeding.
Lactation Use
Nimodipine is not recommended for women who are breastfeeding due to the potential risks to the infant.
Acute Overdose
An acute overdose of nimodipine may result in symptoms such as dizziness, confusion, drowsiness, hypotension, tachycardia, arrhythmias, and respiratory depression. If an overdose is suspected, it is important to seek medical attention immediately.
Contraindication
Nimodipine is contraindicated in patients with a known hypersensitivity to dihydropyridine calcium channel blockers. It should also not be used in patients with hypotension or heart block due to the risk of further reduction in blood pressure or bradycardia. Nimodipine should also not be taken with alcohol or other CNS depressants.
Use Direction
Nimodipine should be taken orally, typically every four hours. It may be taken with or without food. Patients should not exceed the recommended dose of 60 mg every four hours and should not take more than 21 doses in a 24 hour period.
Storage Conditions
Nimodipine should be stored in a cool, dry place at room temperature. It should be kept in its original container and away from light, heat, and moisture.
Volume of Distribution
Nimodipine has a volume of distribution of approximately 2L/kg.
Half Life
Nimodipine has an elimination half-life of approximately 3 hours.
Clearance
Nimodipine is largely eliminated from the body via the kidneys, though a small amount is excreted unchanged in the urine.
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