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Nimodipine

Dihydropyridine, calcium channel blocker

CCP: Subarachnoid hemorrhage

 

  • Hypersensitivity
  • Concomitant use with phenobarbital, phenytoin, carbamazepine, or rifampin
  • Concomitant use with strong CYP3A4 inhibitors

CCP: Intracranial hemorrhage

  • 60 mg PO q 4 hours
  • No data for pediatric use.

Not supplied by BCEHS

Tablet 30 mg

 

Nimodipine shares the pharmacology of other calcium channel blockers but with a greater affinity on cerebral arterials than other arterials. This increased specificity may be due to the drug's increased lipophilicity and cerebral distribution as compared to nifedipine. Nimodipine inhibits calcium ions from entering the “slow channels” or select voltage sensitive areas of vascular smooth muscle and myocardium during depolarization.

Time to peak: 0.25-1.05 hours

Half-life: 1-2 hours

 

Cardiovascular

  • Decreased blood pressure, bradycardia, hypertension, palpitations

Hematological

  • Anemia, decreased platelet count,
  • DIC, hematoma, thrombocytopenia

Central nervous system

  • Headache, dizziness

Dermatological

  • Diaphoresis, flushing, edema, pruritus

Gastrointestinal

  • Nausea, vomiting
  • Gastrointestinal hemorrhage, gastrointestinal pseudo-obstruction, intestinal obstruction

Hepatic

  • Hepatitis, increased lactate dehydrogenase, increased serum alkaline phosphatase, increased serum ALT, jaundice

 

  • Increased angina and/or MI have occurred with initiation or dosage titration of dihydropyridine calcium channel blockers.
  • Reflex tachycardia may occur resulting in angina and/or MI in patients with obstructive coronary disease.
  • Use with caution in patients with cirrhosis due to the increased plasma concentrations of nimodipine and an increased risk of adverse reactions.
  • Use with caution in patients with hypertrophic cardiomyopathy with outflow tract obstruction.
  • Nimodipine has inadvertently been administered IV when withdrawn from capsules into a syringe for subsequent nasogastric administration. Severe cardiovascular adverse events, including fatalities, have resulted.

 

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