Nimodipine (Oral)

Patients who experience a ruptured blood vessel in their brain can have continued symptoms that are brought on by the damage caused from the subarachnoid hemorrhage, and such patients often find relief by taking nimodipine which increases the flow of blood to the affected brain tissue.

Overview

Nimodipine is a prescription drug that is effective in patients who experience ongoing symptoms following a subarachnoid hemorrhage (ruptured blood vessel in their brain). This medication helps to relieve symptoms by increasing the flow of blood to the damaged brain tissue.

This medication has been reported to cause lightheadedness and even fainting in some cases. Patients are advised to understand how nimodipine affects them prior to undertaking any activity that requires full alertness, such as operating heavy machinery or driving an automobile.

Nimodipine should be taken within 96 hours of an incident of a ruptured blood vessel, and it is very important that patients follow all medical advice and take this medication even in circumstances where they do not feel any symptoms or ailments.

Inform your doctor and medical team of all medications that you are currently taking or have recently stopped taking. This includes all prescription and non-prescription medications as well as any herbal remedies, and all vitamin and mineral supplements.

Patients will need to undergo regular diagnostic testing while taking nimodipine, and will also need to monitor their blood pressure. Any significant changes in blood pressure levels should be reported to your physician right away.

Take this medication exactly as prescribed as it can help to minimize the effects of a blood vessel rupture in the brain. Be sure to take the entire course of treatment of nimodipine even if you begin to feel better or your symptoms begin to dissipate. Do not make any changes to how you take this medication.

The prescription drug nimodipine comes in the following dosage delivery methods:

  • Solution
  • Liquid-filled capsule
  • Tablet

Conditions Treated

Type Of Medicine

  • Calcium channel blocker
  • Dihydropyridine

Side Effects

As with most medications, nimodipine can cause some unwanted side effects in addition to its prescribed purpose. There are some symptoms that require immediate medical attention, while others will likely go away on their own. Patients are advised to familiarize themselves with the different types of side effects and the appropriate response to each. If any side effect or symptom becomes worse or lingers longer than a few days, it is recommended that the patient notify their doctor for further medical advice.

Patients are advised to inform their doctors of any allergies that they may have, including allergic reactions to medication, food, animals, cleaning solutions, or any other substances. If you experience any type of negative and significant reaction when taking nimodipine, notify your doctor right away.

The following list of side effects and symptoms can sometimes be a sign of a more serious issue. Familiarize yourself with this list of symptoms, and understand the appropriate action to take should they occur. Patients are advised to contact their doctors right away if they experience any of the side effects listed below:

Less likely:

  • Irregular pulse
  • Blurred vision
  • Swelling
  • Confusion
  • Slow or irregular heartbeat
  • Accelerated heartbeat or pulse
  • Irregular heartbeat
  • Hard-pounding heartbeat
  • Shortness of breath
  • The feeling of lightheadedness
  • Dizziness
  • Fainting
  • Sweating
  • Difficult or labored breathing
  • Tightness in the chest area
  • Chest pain or discomfort
  • Unexplained tiredness or weakness

While your body is adjusting to the introduction of nimodipine into your system, certain side effects may occur that will likely dissipate on their own as your body acclimates to the medication. If you experience any of the symptoms listed below and they do not go away after a few days, or they become worse, contact your doctor for further medical advice:

Less likely:

  • Trouble sleeping
  • Blemishes on the skin
  • Tiredness
  • Diarrhea
  • Rash
  • Feeling empty
  • Sadness
  • Nausea or vomiting
  • Indigestion
  • Loss or lack of appetite
  • Abdominal or stomach cramps
  • Muscle pain
  • Irritability
  • Pimples
  • Headaches
  • Swollen mouth and tongue
  • Discouragement
  • Trouble concentrating
  • Constipation
  • Unpleasant taste
  • Back pain
  • Urge to have a bowel movement
  • Loss of interest or pleasure

While these lists aim to be comprehensive, it is possible that you may experience further symptoms and side effects that are not listed here. If you have any reactions that cause you concern, linger for more than a few days, or worsen, it is advised that you speak with your doctor right away for further instructions. Any symptom or side effect that you experience that causes you worry should be reported to your doctor. It is always best practice to consult with your prescribing physician if you have any concerns with the way that your body is reacting to nimodipine.

Dosage

This medication is typically given to patients within the first 96 hours following the rupture of a blood vessel in their brain. It is important that this medication is taken as directed even if no symptoms or illness is felt by the patient. Be sure to take this medication exactly as your doctor directs, do not take more or less, and do not skip any doses. Contact your doctor if you inadvertently miss a dose and are unsure what to do. Do not ever take a double dose of nimodipine.

Patients are advised to take nimodipine either two hours following a meal or one hour prior to eating. Do not eat grapefruit or imbibe any grapefruit juice while taking this medication.

A nasogastric tube (NGT) can be utilized when taking nimodipine; simply poke a hole in the ends of the medicine capsule and utilize a syringe to remove the medication from its covering. The syringe can then be used to administer the dosage orally or it can be delivered through the NGT. This procedure is also an effective option for patients who are unable to swallow the nimodipine capsule. Never administer nimodipine via injection.

  • For patients taking the oral liquid:

Do not rely upon common household utensils to measure your medication as their level of accuracy is often not accurate enough. Patients are advised to utilize an oral syringe, medicine cup, or a clearly marked measuring spoon.

When delivered through an NGT or gastric tube, the oral syringe should be utilized to measure the proper dosage. After administering the dosage it is important that a saline flush is done in order to capture any medicine that has been stuck in the tubes. If you are going to utilize this delivery method be sure to understand the proper procedure and confer with a member of your medical team if you are unsure of what to do at any time.

  • Patients taking nimodipine to treat subarachnoid hemorrhage:
  • Patients who are utilizing the capsule form of delivery:

Take 60 milligrams, in two 30 milligram capsules, once every four hours for a three-week period.

  • Patients who are utilizing the solution form of delivery:

Take 20 milliliters once every four hours for a three-week period.

Major Drug Interactions

Similar to most medications, there are certain drugs that are contraindicated for use with nimodipine. It is important that your doctor is aware of all medications that you are currently taking or have recently stopped taking. If nimodipine is determined to be the most effective drug for use in treating your subarachnoid hemorrhage your doctor may change a medication that you are taking for another purpose. There are other medications that can increase the patient's likelihood for unwanted side effects, or cause complications; if you are taking one of these drugs your doctor may alter the way that one or both of the medications are taken.

Many medications can cause unwanted side effects or other complications when used in combination with nimodipine. If you are taking one of the following medications your doctor may change your prescription or determine that nimodipine is not the most appropriate drug for use in your situation:

  • Boceprevir
  • Telaprevir
  • Conivaptan
  • Ritonavir
  • Indinavir
  • Nelfinavir
  • Lopinavir
  • Posaconazole
  • Ketoconazole
  • Saquinavir
  • Delavirdine
  • Telithromycin
  • Clarithromycin
  • Nefazodone
  • Voriconazole

The use of the following drugs concurrently with nimodipine is not considered optimal, but it may be the most effective treatment for your situation. If your doctor makes this determination, they may alter the way that you take one or both of the medications:

  • Carbamazepine
  • Rifampin
  • Clopidogrel
  • Phenobarbital
  • Dantrolene
  • Idelalisib
  • Digoxin
  • Lacosamide
  • Dexamethasone
  • Phenytoin
  • Cobicistat
  • Rifapentine
  • Ceritinib
  • Fosphenytoin
  • St John's Wort

The use of the following drugs with nimodipine may increase your likelihood of experiencing unwanted side effects. Your doctor may change the way that you take these drugs or alter the dosage amount:

  • Quinupristin
  • Dalfopristin
  • Valproic Acid

Patients who suffer from the following medical condition may experience further complications or the use of nimodipine may worsen their liver disease. If you are taking this medication while also suffering from the following condition your doctor may require additional diagnostic testing or alter the way in which you take nimodipine:

  • Liver disease

Warnings

Your doctor may order certain diagnostic tests while you are taking nimodipine in order to measure its effectiveness and also to manage and monitor the presence of any unwanted side effects. It is important that patients keep all appointments and undergo all testing as scheduled.

It is important for patients to have their blood pressure monitored while they are taking nimodipine. Any patient who experiences any significant changes in their blood pressure while taking nimodipine should notify their doctor of such changes right away.

Nimodipine has been reported to cause fainting, lightheadedness, and dizziness in patients while they are taking this medication. Be sure to understand how this medication affects you before you undertake any activity that requires full alertness, such as driving a car or operating heavy machinery. If you begin to feel dizzy, sit down and place your head between your knees to reduce the chance of fainting. Remain in a seated position until the feelings of lightheadedness dissipate.

Do not eat grapefruit or drink any grapefruit juice while you are taking nimodipine as it can interfere with the effectiveness of the medication.

Patients are advised to confer with their doctor with any questions that they have while taking this medication.

Storage

It is always best practice to store medication in its original packaging. Do not keep any excess, unused, or expired medications; if you are unsure of the proper disposal method for this medication, contact your pharmacist for further advice.

This medication should be stored at room temperature and not exposed to direct light, extreme heat or cold, or moisture. Do not allow the nimodipine to freeze.

Patients who are taking the oral formulation should keep the medication at room temperature rather than refrigerate it.

Keep this and all medications out of the reach of both pets and young children.

Summary

Nimodipine is a prescription drug that is effective in patients who experience ongoing symptoms following a subarachnoid hemorrhage (ruptured blood vessel in their brain). This medication helps to relieve symptoms by increasing the flow of blood to the damaged brain tissue.

This drug is most effective when taken within 96 hours of the blood vessel rupture. Patients are strongly encouraged to take nimodipine exactly as directed even in situations where they feel fine and are not experiencing any symptoms. Take this medication exactly as directed and do not make any changes to how you take it or stop taking it, without first speaking with your doctor.

Nimodipine is effective in repairing damage to the brain tissue affected by the blood vessel rupture by helping to increase the flow of blood to the tissue in the affected area. If you feel that the medication is not effective or is not working as expected, be sure to discuss your concerns with your doctor prior to making any changes to how you take this medication.

Patients are advised to take the entire course of treatment of nimodipine as directed by their physician even if their symptoms begin to dissipate or the patient is beginning to feel better.