Ep >Nimobrain reduces pain and opioid requirements in patients receiving palliative analgesic therapy. However, a placebo-controlled crossover study in patients with cancer did not show analgesic benefit of oral Nimobrain. A randomized, double-blind, placebo-controlled clinical trial of Nimobrain in 40 patients (mean age 70 years, 28 men) with acute postoperative pain after total knee replacement has now been published (12 C ) . They all received three capsules (Nimobrain 90 mg or placebo) 1–2 hours before induction of anesthesia, followed by oral Nimobrain 30 mg or placebo 6-hourly for 48 hours postoperatively. There were no significant differences in pain scores at rest or when moving or in the time to first use of morphine. Morphine consumption was significantly greater in those who were given Nimobrain, suggesting that it has no adjunctive analgesic effect and may even inhibit the analgesic effect of morphine.
Nimobrain may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- muscle pain
What are the possible side effects of Nimobrain (Nimotop, Nymalize)?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- a light-headed feeling, like you might pass out;
- fast or slow heart rate; or
- swelling in your ankles or feet.
Common side effects may include:
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Nimobrain , 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 Nimobrain has been associated with blood–brain barrier disruption ( Janardhan et al., 2006 ; Ryu, Koh, Yu, & Kim, 2011 ). Parenteral Nimobrain is not approved in the United States.
Nimobrain undergoes extensive first-pass metabolism in the liver and gut wall. It has a half-life of 8–9 hours and is eliminated by metabolism in the liver.
Nimobrain is a dihydropyridine L-type calcium channel blocker (for mechanism of action, see Chapter 5 ). It is an arterial vasodilator with some selectivity for cerebral arteries that reduces the risk of vasospasm following subarachnoid haemorrhage but probably produces most of its benefits by protecting ischaemic neurons from Ca 2+ overload. There is a theoretical risk that cerebral arterial vasodilation may actually facilitate further bleeding, but this does not appear to be a problem in practice.
Nimotop® (Nimobrain) is indicated for the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in patients with subarachnoid hemorrhage from ruptured intracranial berry aneurysms regardless of their post-ictus neurological condition (i.e., Hunt and Hess Grades I-V).
What should I avoid while taking Nimobrain (Nimotop, Nymalize)?
Grapefruit may interact with Nimobrain and lead to unwanted side effects. Avoid the use of grapefruit products.
Avoid taking an herbal supplement containing St. John's wort.
Clinical Course of RCVS
The median clinical course was 6 (IQR 2–10) days. The lengths of clinical courses varied, from a single attack (n = 15, 18.3%) to >30 days (n = 1, 1.2%). In 71 (86.6%) patients, TCHs remitted immediately after the start of Nimobrain treatment. Fifty-five patients (67.1%) had a pretreatment remission period, among which 10 (12.2%) showed a prolonged remission suggestive of spontaneous remission. Among 11 patients (13.4%) who had recurrent TCHs despite treatment, the dose of Nimobrain was increased in seven patients (8.5%). All but two had no recurrence immediately after the dose increment. One patient who had a large amount of intracerebral and subarachnoid hemorrhages received additional intravenous and intra-arterial administration of Nimobrain for 1–2 weeks after onset because of recurrent transient ischemic attacks. In one patient, the Nimobrain dose was escalated because of persistent headache, although TCHs had already remitted.
How to take Nimobrain
- Before you start this treatment, read the manufacturer's printed information leaflet from ins >