Nimodipine Uses, Dosage, and Side Effects Overview

Key Points About Nimodipine

Nimodipine is primarily used to prevent brain damage caused by bleeding, such as after a subarachnoid hemorrhage. It works by relaxing blood vessels in the brain, improving blood flow, and reducing the risk of complications. Nimodipine is also used for conditions like ischemic stroke and migraines. Always consult a healthcare provider before starting or adjusting your dose. You can also consult one of our providers through telemedicine today.

Nimodipine Medication Names

US Brand Name: Nimotop

Generic Name: Nimodipine

The generic name refers to the active ingredient, while the brand name is what the drug is sold under. In this case, Nimodipine is the generic name.

Pharmacologic Category of Nimodipine

Calcium Channel Blocker

Dihydropyridine

Nimodipine Dosage Guidelines

Nimodipine is prescribed for various conditions, and the dosage may vary depending on the condition being treated. Always follow your healthcare provider’s instructions and never adjust your dose without consulting them. You can also consult one of our telemedicine providers for personalized advice.

Nimodipine for Subarachnoid Hemorrhage

Dosage: 60 mg orally every 4 hours for 21 days.

This is the most common use of Nimodipine, aimed at preventing complications such as cerebral vasospasm after brain bleeding.

Nimodipine for Cerebral Vasospasm

Dosage: 60 mg orally every 4 hours for up to 21 days.

Nimodipine helps relax blood vessels in the brain, reducing the risk of further damage.

Nimodipine for Ischemic Stroke

Dosage: 30-60 mg orally every 4-6 hours, depending on the severity of the condition.

Nimodipine may be used to improve blood flow to the brain after a stroke caused by arterial blockage.

Nimodipine for Migraine Prevention

Dosage: 30 mg orally every 6 hours, as prescribed by your doctor.

Nimodipine is sometimes used off-label to prevent migraines by improving blood flow in the brain.

Nimodipine for Hypertension

Dosage: 30-60 mg orally every 6 hours, depending on your blood pressure levels.

Though not commonly used for hypertension, Nimodipine may be prescribed to lower blood pressure by relaxing blood vessels.

Nimodipine for Angina

Dosage: 30 mg orally every 6 hours.

Nimodipine can help reduce chest pain (angina) by improving blood flow to the heart.

Nimodipine for Peripheral Vascular Disease

Dosage: 30-60 mg orally every 6 hours.

This medication may help improve blood flow in conditions affecting blood vessels outside the heart and brain.

Nimodipine for Heart Failure

Dosage: 30-60 mg orally every 6 hours.

Nimodipine may be prescribed to improve heart function by reducing the heart’s workload.

Nimodipine for Aneurysm

Dosage: 60 mg orally every 4 hours for 21 days.

Nimodipine is used to prevent complications after an aneurysm, particularly in the brain.

Nimodipine for Dementia

Dosage: 30 mg orally every 6 hours.

In some cases, Nimodipine may be used off-label to improve cognitive function in dementia patients, though this is not a common use.

Nimodipine Dosage Forms and Strengths

Capsules: 30 mg

Oral Solution: 60 mg/20 mL

How to Take Nimodipine: Administration Instructions

Nimodipine should be taken orally, usually every 4 to 6 hours, depending on your doctor’s prescription. It is important to take it on an empty stomach, either 1 hour before or 2 hours after a meal. If using the liquid form, measure the dose carefully with a special measuring device. Do not inject Nimodipine; it is meant for oral use only. If you miss a dose, take it as soon as you remember unless it’s almost time for the next dose. In that case, skip the missed dose and continue your regular schedule. Do not double up on doses.

Nimodipine Contraindications

A contraindication is a specific situation or condition in which a medication should not be used because it may be harmful. If you have any of the following conditions, Nimodipine may not be safe for you:

1. Allergy to Nimodipine or similar medications: If you’ve had an allergic reaction to Nimodipine or other calcium channel blockers, taking this medication could trigger a severe allergic response, including difficulty breathing, swelling, or rash.
2. Severe liver impairment: Nimodipine is processed by the liver. If your liver is not functioning properly, the medication may not be broken down correctly, leading to higher levels in the bloodstream and potentially dangerous side effects.
3. Low blood pressure (hypotension): Nimodipine lowers blood pressure. If you already have low blood pressure, taking this medication could cause it to drop further, leading to dizziness, fainting, or even shock.
4. Use of intravenous (IV) administration: Nimodipine is only approved for oral use. Administering it intravenously can cause serious cardiovascular complications, including heart attacks and death.

If you have any of these conditions, please consult with one of our healthcare providers through telemedicine before starting or continuing Nimodipine.

Nimodipine Drug Interactions

Nimodipine can interact with other medications, which may affect how well it works or increase the risk of side effects. Be sure to tell your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Here are some common medications that may interact with Nimodipine:

1. Rifampin (Rifadin): This antibiotic can decrease the effectiveness of Nimodipine by speeding up its breakdown in the liver.
2. Phenytoin (Dilantin): This anti-seizure medication may reduce the levels of Nimodipine in your blood, making it less effective.
3. Carbamazepine (Tegretol): Another anti-seizure drug that can lower Nimodipine levels, reducing its effectiveness.
4. Ketoconazole (Nizoral): This antifungal medication can increase the levels of Nimodipine in your blood, raising the risk of side effects.
5. Clarithromycin (Biaxin): An antibiotic that may increase the concentration of Nimodipine in your bloodstream, potentially leading to dangerous side effects like low blood pressure.
6. Grapefruit juice: Grapefruit juice can increase the levels of Nimodipine in your blood, leading to an increased risk of side effects such as dizziness or fainting.

If you are taking any of these medications, please consult with one of our healthcare providers through telemedicine to discuss potential adjustments to your treatment plan.

Nimodipine in Pregnancy

Is it safe to take Nimodipine when pregnant?

Nimodipine is classified as a Category C drug for pregnancy by the FDA. This classification means that while there are no well-controlled studies in humans, animal studies have shown potential risks to the fetus. In certain cases, such as when the mother has a life-threatening condition like a subarachnoid hemorrhage, the potential benefits of using Nimodipine during pregnancy may outweigh the risks. However, it is crucial to discuss the risks and benefits with your healthcare provider before taking Nimodipine during pregnancy.

Nimodipine while Breastfeeding

Is it safe to take Nimodipine while breastfeeding?

There is limited information on whether Nimodipine passes into breast milk. Due to the potential for serious side effects in nursing infants, it is generally recommended to avoid breastfeeding while taking Nimodipine. If you are breastfeeding or plan to breastfeed, consult your healthcare provider about alternative treatments or the possibility of switching to formula feeding while on this medication.

Estimated Cost of Nimodipine Medication

The cost of a 30-day supply of Nimodipine (60 mg, taken every 4 hours) without insurance can vary. However, using a GoodRx coupon, the price typically ranges from $300 to $500. Prices may differ depending on the pharmacy and location. Be sure to check for discounts or coupons that may help reduce the cost of Nimodipine medication.

Possible Alternatives to Nimodipine

If Nimodipine is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss any changes to your treatment plan with your healthcare provider. You can also schedule a telemedicine appointment with one of our providers to explore your options.

Subarachnoid Hemorrhage

Other calcium channel blockers, such as Verapamil (Calan), may be considered. In some cases, surgery or endovascular therapy may be necessary to treat the underlying aneurysm.

Cerebral Vasospasm

In addition to Nimodipine, other vasodilators or endovascular treatments may be used to improve blood flow in the brain.

Ischemic Stroke

Antiplatelet medications like Aspirin or Clopidogrel (Plavix) are commonly used. Thrombolytic therapy (clot-busting drugs) may also be an option during the acute phase of a stroke.

Migraine

Beta-blockers like Propranolol (Inderal), anti-seizure medications, or triptans (such as Sumatriptan) may be effective alternatives. Lifestyle changes, including stress management and maintaining a regular sleep schedule, can also help reduce migraine frequency.

Hypertension

ACE inhibitors like Lisinopril (Zestril), beta-blockers, or diuretics may be prescribed to manage high blood pressure. Additionally, reducing salt intake, exercising regularly, and managing stress are important lifestyle changes that can support treatment.

Angina

Nitrates like Nitroglycerin, beta-blockers, or lifestyle changes such as quitting smoking and engaging in regular physical activity may help manage angina symptoms.

Peripheral Vascular Disease

Medications like Cilostazol (Pletal) or lifestyle changes, including quitting smoking and increasing physical activity, may improve symptoms of peripheral vascular disease.

Heart Failure

ACE inhibitors, beta-blockers, and diuretics are commonly used to manage heart failure. Lifestyle changes, such as reducing salt intake and monitoring fluid levels, can also play a significant role in managing the condition.

Aneurysm

Surgical intervention or endovascular coiling may be required to treat an aneurysm. Regular monitoring and controlling blood pressure are essential for managing the condition.

Dementia

Cholinesterase inhibitors like Donepezil (Aricept) or lifestyle changes, such as engaging in cognitive exercises and maintaining a healthy diet, may help slow the progression of dementia.

Recent Updates on Nimodipine Research

Recent studies have explored the potential use of Nimodipine beyond its current indications. Some research suggests that Nimodipine may have neuroprotective effects in conditions like traumatic brain injury and Alzheimer’s disease, although more studies are needed to confirm these findings. Additionally, ongoing clinical trials are investigating the use of Nimodipine in ischemic stroke recovery, with early results showing promise in improving outcomes when used in combination with other therapies.

As research continues to evolve, it is important to stay informed about new developments. If you are interested in learning more about how these findings may affect your treatment, schedule a telemedicine consultation with one of our providers today.

James Kingsley

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