COMMON BRAND(S): Nymalize
GENERIC NAME(S): Nimodipina
OTHER NAME(S): Nimodipina Capsule
This medication should not be given by injection. Accidental injection of Nimodipina can cause serious (rarely fatal) side effects (such as low blood pressure, slow heartbeat). Consult your doctor or pharmacist for details.
Nimodipina is used to decrease problems due to a certain type of bleeding in the brain (subarachnoid hemorrhage-SAH).
Nimodipina is called a calcium channel blocker. The body naturally responds to bleeding by narrowing the blood vessel to slow blood flow. However, when the bleeding is in the brain, stopping blood flow causes more brain damage. Nimodipina is thought to work by relaxing narrowed blood vessels in the brain near the area of bleeding so blood can flow more easily. This effect reduces brain damage.
Nimodipina , 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 Nimodipina has been associated with blood–brain barrier disruption ( Janardhan et al., 2006 ; Ryu, Koh, Yu, & Kim, 2011 ). Parenteral Nimodipina is not approved in the United States.
Nimodipina 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.
Getting the most from your treatment
- Remember to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- Do not drink grapefruit juice while you are on Nimodipina. This is because a chemical in grapefruit juice can increase the amount of Nimodipina in your bloodstream and this increases the risk of side-effects. This effect can last for at least four days.
- If you drink alcohol, ask your doctor for advice. Your doctor may recommend that you do not drink alcohol while you are on this medicine, as it may increase the chance that you experience side-effects, such as feeling dizzy or light-headed.
- If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.
- If you need to have an operation or any medical treatment, remember to tell the person carrying out the treatment which medicines you are taking. Nimodipina and some anaesthetics can interact, meaning that unwanted effects are more likely.
There have been no reports of overdosage from the oral administration of Nimodipina. Symptoms of overdosage would be expected to be related to cardiovascular effects such as excessive peripheral vasodilation with marked systemic hypotension. Clinically significant hypotension due to Nimodipina overdosage may require active cardiovascular support with pressor agents. Specific treatments for calcium channel blocker overdose should also be given promptly. Since Nimodipina is highly protein-bound, dialysis is not likely to be of benefit.
Oral Nimodipina was prescribed immediately upon a diagnosis of suspected RCVS. Initial treatment was started at 30 mg every 8–12 h per day (median, 1.5 mg/kg/day). If TCHs effectively remitted with this regimen, the dose of Nimodipina was unchanged for 3 months. In patients (n = 7, 8.5%) who had recurrent TCHs or persistent headache of more than moderate intensity, the dose of Nimodipina was escalated and maintained when tolerated. We recorded the date of Nimodipina administration and dose increment in all patients. We measured SBP and diastolic BP (DBP) at every visit.
What is the most important information I should know about Nimodipina (Nimotop, Nymalize)?
Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.
The liquid from a Nimodipina capsule should never be injected through a needle into the body, or death may occur.
Why is this medication prescribed?
Nimodipina is used to decrease brain damage that may be caused by a subarachnoid hemorrhage (bleeding in the space surrounding the brain that occurs when a weakened blood vessel in the brain bursts). Nimodipina is in a class of medications called calcium channel blockers. It works by relaxing blood vessels in the brain to allow more blood to flow to damaged areas.
"Oral Nimodipina should be administered to all patients with aSAH. (It should be noted that this agent has been shown to improve neuro-logical outcomes, but not cerebral vasospasm. The value of other calcium antagonists, whether administered orally or intravenously, remains uncertain.)"
- Guideline Rating: Class I; Level of Evidence A
- Reference: Connolly ES et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2012;43(6):1711-37. PubMed