Buy Nimotop Online

Nimodipine (nimodipine)

BOXED WARNING

Do not administer IV or by other parenteral routes. Deaths and serious, life-threatening adverse events have occurred when the contents of caps have been injected parenterally.

OTHER BRAND NAMES

Nimotop (Discontinued)

THERAPEUTIC CLASS

Calcium channel blocker (CCB)

DEA CLASS

RX

INDICATIONS

Improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in patients with subarachnoid hemorrhage (SAH) from ruptured intracranial berry aneurysms regardless of their post-ictus neurological condition (eg, Hunt and Hess Grades I-V).

ADULT DOSAGE

Subarachnoid Hemorrhage

Indicated for the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in patients w/ subarachnoid hemorrhage (SAH) from ruptured intracranial berry aneurysms regardless of their post-ictus neurological condition (eg, Hunt and Hess Grades I-V)

Usual: 60mg q4h for 21 days; begin therapy w/in 96 hrs of onset of SAH

DOSING CONSIDERATIONS

Hepatic Impairment
Cirrhosis: Reduce to 30mg q4h; consider discontinuation of therapy, if necessary

ADMINISTRATION

Oral route

Swallow caps whole w/ a little liquid, preferably not less than 1 hr before or 2 hrs after meals
If patient cannot swallow cap, extract contents into syringe, empty into NG tube, and wash down the tube w/ 30mL of 0.9% NaCl
Do not administer nimodipine capsules IV or by other parenteral routes

HOW SUPPLIED

Cap: 30mg

CONTRAINDICATIONS

Concomitant use with strong CYP3A4 inhibitors such as some macrolide antibiotics (eg, clarithromycin, telithromycin), some anti-HIV protease inhibitors (eg, indinavir, ritonavir, saquinavir), some azole antimycotics (eg, ketoconazole, itraconazole, voriconazole), and some antidepressants (eg, nefazadone).

WARNINGS/PRECAUTIONS

Lowering of BP reported; carefully monitor BP. Decreased metabolism in patients with impaired hepatic function; closely monitor BP and pulse rate and give a lower dose. Rare reports of intestinal pseudo-obstruction and ileus. Caution in elderly.

ADVERSE REACTIONS

Decreased BP, diarrhea.

DRUG INTERACTIONS

See Contraindications. Strong CYP3A4 inducers (eg, rifampin, phenobarbital, phenytoin) may significantly reduce levels and efficacy; avoid concomitant use. Moderate and weak CYP3A4 inhibitors (eg, amiodarone, erythromycin, valproic acid) may increase levels; monitor BP and reduce nimodipine dose if necessary. Not recommended with grapefruit/grapefruit juice. Moderate and weak CYP3A4 inducers (eg, efavirenz, pioglitazone, prednisone) may reduce efficacy; increase in nimodipine dose may be required. May increase the BP lowering effect of antihypertensives; monitor BP and dose adjustment of the BP lowering drug(s) may be necessary.

PREGNANCY AND LACTATION

Category C, not for use in nursing.

MECHANISM OF ACTION

CCB; has not been established. Inhibits Ca2+ ion transfer into smooth muscle cells, thereby inhibiting contractions of vascular smooth muscle.

PHARMACOKINETICS

Absorption: Rapid; Tmax=1 hr; bioavailability (13%). Distribution: Plasma protein binding (>95%). Metabolism: Via CYP3A4. Elimination: Urine (<1% unchanged); T1/2=8-9 hrs.

ASSESSMENT

Assess for hepatic impairment, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for intestinal pseudo-obstruction, ileus and other adverse reactions. Carefully monitor BP and pulse rate.

PATIENT COUNSELING

Inform about potential risks/benefits of therapy.

STORAGE

20-25°C (68-77°F). Protect from light and freezing.

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