Nimodipine is used to reduce problems caused by subarachnoid hemorrhage-SAH. The body naturally responds to bleeding by narrowing blood vessels to slow blood flow. However, when blood has flowed into the brain, stopping blood flow will cause more damage to the brain.
1. What does Nimodipine do?
Nimodipine belongs to the group of calcium channel blockers. Nimodipine works by dilating narrowed blood vessels in the brain near the bleeding area so that blood can flow more easily, thereby reducing brain damage.
Nimodipine is indicated in the following cases:
- Idiopathic tremor
- Subarachnoid hemorrhage
Nimodipine is contraindicated in the following cases:
- Low blood pressure
- Liver disease
- Chronic idiopathic constipation
2. How to use Nimodipine
Read the instructions carefully from your doctor before taking nimodipine and each time you get a refill. If you have any questions about how to use Nimodipine, ask your doctor.
Nimodipine should be started as soon as possible after bleeding in the brain begins, usually within 4 days. Nimodipine is used as directed by your doctor, usually every 4 hours, 1 hour before or 2 hours after meals.
If you are taking the tablet form of Nimodipine, take it with a full glass of water (240 milliliters), unless your doctor tells you otherwise. Do not lie down for at least 10 minutes after taking this medication. Swallow the tablet whole; do not crush it.
If you are taking the capsule form of Nimodipine, take it as directed by your doctor, swallowing the capsule whole. If you cannot swallow a capsule whole, you may puncture a hole in the capsule, draw out the liquid with a syringe, and drink it by mouth or through a feeding tube using a syringe. Do not mix the capsule with other liquids. Doing so may prevent the medication from working. This medication is not for injection.
If you are using the liquid form (oral solution) of Nimodipine, measure the dose carefully using a special measuring device/spoon. Some brands of this medication may come in a prefilled oral syringe with the correct dose.
Avoid eating grapefruit or drinking grapefruit juice while using Nimodipine unless your doctor says you may do so safely. Grapefruit can increase the risk of side effects with this medication.
Your dose of Nimodipine is based on your medical condition and response to treatment. Use Nimodipine regularly to get the most benefit from it.
To help you remember to take your medication, take it at the same time each day. Continue taking Nimodipine even if you feel well and even if you do not see any improvement in your symptoms.
Do not suddenly stop taking Nimodipine without consulting your doctor. This medication is usually taken for 2 to 4 weeks, your condition may become worse if you stop taking it too soon.
Tests such as liver function, and checks on your blood pressure and heart rate may be done from time to time to monitor your progress or check for side effects while taking Nimodipine.
Tell your doctor if your condition worsens after taking Nimodipine.
3. Side effects of Nimodipine
While using Nimodipine, you may feel dizzy, lightheaded, flushed, or swollen ankles/feet. If any of these side effects persist or worsen, tell your doctor immediately.
To reduce dizziness and lightheadedness while using Nimodipine, get up slowly when rising from a sitting or lying position.
Remember that your doctor has prescribed Nimodipine because he or she has judged that the benefit to you is greater than the risk of side effects. Many people who use Nimodipine do not have serious side effects.
Tell your doctor right away if you have any serious side effects of Nimodipine, including: Fainting, slow or fast heartbeat, stomach ache, bloating, severe nausea or vomiting, vision changes.
A very serious allergic reaction to Nimodipine is rare. However, if you notice any symptoms of a serious allergic reaction to Nimodipine, including: Rash, itching/swelling (especially of the face/tongue/throat), difficulty breathing, dizziness, seek medical help right away.
Below are the side effects of Nimodipine, listed by likelihood.
Common side effects of Nimodipine include:
- Slow heart rate
- Low blood pressure
- Headache
- Nausea
Less common side effects of Nimodipine include:
- Fluid retention in the hands or feet
- Muscle pain
- Diarrhea
Rare side effects of Nimodipine include:
- Low platelet count
- Depression
- Abnormal electrical signals of the heart
- Chronic heart failure
- Fluid in the lungs
- Allergic dermatitis
- Skin rash
- Fast heartbeat
- Acne
- Cramps
- Dizziness
- Visible fluid retention
- Temporary redness of the face and neck
This is not a complete list of possible side effects of Nimodipine. If you notice other side effects of Nimodipine that are not listed above, contact your doctor for timely treatment.
4. Precautions for side effects of Nimodipine
Before taking nimodipine, tell your doctor if you are allergic to this drug or other dihydropyridine calcium channel blockers (such as amlodipine, nifedipine) and any other allergies. Nimodipine products may contain inactive ingredients, which can cause allergic reactions or other problems.
Before using Nimodipine, tell your doctor your medical history, especially of: recent chest pain or heart attack, low blood pressure, recent head injury, liver disease.
Nimodipine can make you dizzy, and alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness while using Nimodipine, until you are sure you can do it safely.
Before having surgery, tell your doctor or dentist that you are taking Nimodipine.
Older people may be more sensitive to the side effects of Nimodipine, especially dizziness or swelling of the ankles/feet.
For pregnant women, Nimodipine should be used only when clearly needed. Discuss the risks and benefits with your doctor. Nimodipine passes into breast milk, so women who are breastfeeding should consult their doctor before using it.
5. Nimodipine interactions
Drug interactions may change how Nimodipine works or increase your risk for serious side effects. Tell your doctor about all prescription/nonprescription medications and herbal products you use. Do not start, stop, or change the dosage of any medicines while using Nimodipine without your doctor's approval.
Some products that may interact with Nimodipine are: Medications to treat high blood pressure (such as beta blockers including propranolol and metoprolol, ACE inhibitors such as benazepril and enalapril), other calcium channel blockers (such as diltiazem, verapamil).
Other medications can affect the removal of nimodipine from your body, which may affect how nimodipine works. These medications include apalutamide, cimetidine, enzalutamide, ivosidenib, lumacaftor, mitotane, azole antifungals (such as itraconazole), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), St. John's wort, medication used to treat seizures, carbamazepine, phenytoin, and some others.
6. What to do if you overdose or miss a dose of Nimodipine
If you or someone else has overdosed on Nimodipine and have serious symptoms such as passing out or trouble breathing, call 911 immediately.
If you miss a dose of Nimodipine, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose. Take your next dose of Nimodipine at the regular time. Do not take a double dose.
7. How to store Nimodipine
Store Nimodipine at room temperature, away from light and moisture, do not freeze, do not store in the bathroom and keep the medicine away from children and pets. Dispose of Nimodipine properly when it has expired or is no longer needed.
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