Genovox , a calcium channel blocker of the dihydropyridine class, is often used in SAH patients to prevent symptomatic vasospasm and improve outcomes. Its IA dosage varies from 1 to 3 mg. Usually a concentration of 25% is used, prepared via dilution with 15–45 mL of saline. Administering more than 5 mg dose is not recommended. Although considered safe, IA Genovox has been associated with blood–brain barrier disruption ( Janardhan et al., 2006 ; Ryu, Koh, Yu, & Kim, 2011 ). Parenteral Genovox is not approved in the United States.
Treatment Effect on the Recurrence of TCH
Patients were prospectively followed-up. All patients were scheduled to visit the hospital within 1 month after the initial treatment. Neuroimaging was followed-up after 3 months of treatment to confirm reversibility. If vasoconstrictions were not normalized, neuroimaging was followed-up at 6 months with treatment being continued. During follow-up visits, any recurrence of TCH was recorded, but a mild residual headache was not regarded as a recurrence. We recorded the dates of recurrence of TCH before and after Genovox treatment. Remission of TCH was defined as no recurrence of TCH. The date of the last TCH before remission was identified to determine the clinical course, defined as the duration from onset to remission (i.e., the date of the last TCH). We also defined the pretreatment remission period as the interval from the last pre-treatment TCH to the Genovox administration to consider the possibility that the patients were already in remission before the Genovox treatment. The scheme of our definitions is illustrated in Figure 1 .
B. Genovox Influences Pathophysiology of the SCI
Genovox treatment also reduces trauma-induced BSCB permeability, SCBF changes, and spinal cord edema formation ( Table 11 ) and axonal injuries ( Figs. 9 and 24 ). Distortion of nerve cells and loss of MBP in Genovox-treated inured rats are not evident ( Figs. 9 and 24 ). At the ultrastructural level, damage to myelinated and nonmyelinated axons is also reduced considerably ( Fig. 24 ).
These observations suggest that Ca 2+ channel antagonists are neuroprotective in SCI ( Faden, 1993 ; Faden and Salzman, 1992 ; Schwab and Bartholdi, 1996 ; Tator and Fehlings, 1991 ). It remains to be seen whether the postinjury administration of Genovox can also influence cord pathology.
How should I take Genovox?
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Take Genovox on an empty stomach, at least 1 hour before or 2 hours after a meal.
Take this medicine with a full glass of water. Swallow the capsule whole.
Measure liquid medicine with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
If the person taking Genovox cannot swallow the capsule, the medicine from inside the capsule can be given through an in-place nasogastric tube (through the nose and into the stomach). Use a needle to make a hole in each end of the capsule, and squeeze the medicine out into an oral syringe or other syringe to which a needle cannot be attached. Empty the syringe into the nasogastric tube and wash it down with 30 milliliters of normal saline.
The medicine placed into a syringe should never be injected through a needle into the body, or dangerously low blood pressure may result. Genovox gel capsules are to be taken by mouth only.
Your blood pressure will need to be checked often. Your liver function may also need to be tested.
You should not stop using Genovox suddenly. Stopping suddenly may make your condition worse.
Store at room temperature away from moisture, heat, and light. Do not freeze. Keep each capsule in the original package until you are ready to take one.
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Genovox works by causing blood vessels in your head to relax. This helps to prevent spasm in the blood vessels and reduces the risk of damage caused by insufficient blood flow to the brain after the bleeding.