Nimodipine

Nimodipine

Nimodipine

Mechanism:

Nimodipine is a calcium antagonist of the dihydropyridine group.
It's classified as a vasodilator and hypotensive medicine.

Indications:

For the reduction of cerebral infarction and improvement of outcome after sub-arachnoid haemorrhage.

Contra-Indications:
Safety in pregnancy and lactation has not been established.

Dosage:

Management of overdose:
Symptoms: Hypotension, tachycardia ...also see "side-effects"
Rx: Symptomatic and supportive.

Side-Effects:

Decrease in blood pressure, slight increase or decrease in heart rate, sweating, dizziness, flushing, headache, gastro-intestinal disorders, nausea and the feeling of warmth.
A transient rise in liver enzymes may occur during I/V administration, this usually reverts to normal on completion of treatment.
Thrombocytopaenia and ileus have been reported rarely.

Precautions:

Use with care when cerebral oedema or severely raised intracranial pressure are present.
May potentiate hypotensive effect of antihypertensives.
Concomitant administration of calcium antagonists, alpha-methyl-dopa or beta-blockers should be avoided. Where such co-administration is unavoidable, careful dose titration of nimodipine should be undertaken with possible reduction or discontinuation of the antihypertensive agent.
Caution is required in patients with systolic blood pressure < 90mmHg.
Blood levels of nimodipine may be increased with concomitant administration of cimetidine or anticonvulsant sodium valproate. In patients treated with enzyme inducing anti-convulsants such as phenytoin, phenobarbital and carbamazepine, the plasma concentrations of nimodipine may be markedly reduced.
Patients with known renal disease and/or recieving nephrotoxic drugs, should have renal function monitored closely during I/V treatment.
In patients with severely impaired liver function, dosage reduction may be required.

Pregnancy:
Safety in pregnancy and lactation has not been established.




 
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