Nimodipine is a drug to prevent and treat brain damage due to lack of blood supply when subarachnoid hemorrhage occurs. This drug is available in the form of tablets and intravenous fluids.
Subarachnoid hemorrhage occurs when blood vessels in the protective covering of the brain burst. The body will automatically respond to this bleeding by constricting the blood vessels in the bleeding area, so that blood flow slows down. However, this response can actually cause further brain damage.
Nimodipine works by dilating narrowed brain blood vessels near the bleeding area or preventing them from widening. That way, blood can flow more smoothly and the risk of brain damage can be prevented.
Nimodipine trademarks: Ceremax, Nimodipine, Nimodipine G, Nimodipine 0.02% Infusion, Nimotop.
What is Nimodipine
|Category||Calcium-channel blockers or calcium antagonists|
|Benefit||Treat and prevent brain damage due to subarachnoid hemorrhage.|
|Nimodipine for pregnant and lactating women||
Category C: Studies conducted in animal models have shown an adverse effect on the fetus, but there have been no controlled studies in pregnant women. The drug should only be used if the expected benefit outweighs the risk to the fetus.
Nimodipine can be absorbed into breast milk so it should not be used by mothers who are breastfeeding.
|Drug form||Tablets and IV fluids|
Precautions Before Using Nimodipine
Nimodipine is a prescription drug that should not be used carelessly. There are several things that need to be considered before undergoing treatment with nimodipine, namely:
- Tell your doctor about any history of allergies you have. Nimodipine should not be given to patients who are allergic to it or to other classes of calcium antagonist drugs, such as amlodipine .
- Tell your doctor if you have or have ever had low blood pressure, cirrhosis or other liver disease, porphyria , heart failure, or kidney disease.
- Tell your doctor if you have recently had chest pain, a heart attack , or a head injury.
- Do not drive a vehicle, operate heavy machinery, or do activities that require alertness after using nimodipine, because this drug can cause dizziness.
- Avoid consuming grapefruit and alcohol while using nimodipine, because this will increase the risk of developing hypotension.
- Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy.
- Tell your doctor if you are taking any other medications, including supplements and herbal products.
- Tell your doctor right away if you have an allergic drug reaction , serious side effects, or overdose after using nimodipine.
Dosage and Rules for Use Nimodipine
The dosage and duration of treatment will be determined by the doctor according to the form of the drug, as well as the patient's body condition and response to treatment. Under certain conditions, the doctor will determine the dose of nimodipine according to the patient's weight (BB).
The following is the distribution of nimodipine doses for adults based on the drug form and intended use:
Purpose: To prevent brain damage after subarachnoid hemorrhage
- The dose is 60 mg, consumed every 4 hours, for 21 days. Treatment should be started as soon as possible when bleeding occurs or within 96 hours of bleeding.
Purpose: Treating brain damage due to subarachnoid hemorrhage
- Initial dose of 1 mg per hour, for 2 hours. The dose may be increased to 2 mg per hour if the patient's blood pressure is stable. For patients weighing < 70 kg or patients whose blood pressure is unstable, the initial dose is 0.5 mg hourly.
The duration of treatment with nimodipine infusion can last 5–14 days. The total duration of treatment should not exceed 21 days if the patient is already taking nimodipine tablets.
How to Take Nimodipine Properly
Nimodipine in the form of an infusion will be given directly by a doctor or medical personnel under the supervision of a doctor. This drug will enter into a vein (intravenously) through an infusion.
For nimodipine tablets, follow your doctor 's advice and read the instructions for use listed on the drug packaging before using nimodipine. Do not reduce or increase your dose, or use this medication for more than the time recommended by your doctor.
Nimodipine tablets can be taken with or without food. Swallow the tablet whole with a glass of water. Do not chew, split or crush the tablet. Do not lie down immediately after taking this medicine. Wait at least 10 minutes before lying down.
It is recommended to take nimodipine tablets regularly at the same time every day, so that the effect of the treatment is maximized. If you forget to take this drug, consume it immediately if the break with the next consumption schedule is not too close. If it's close, ignore it and don't double the dose.
During treatment, patients need to periodically monitor their heart rate and blood pressure to monitor response to therapy and be aware of side effects. Do not stop medication without consulting your doctor first.
Store nimodipine tablets in a closed container in a cool room. Do not store it in a damp place or in direct sunlight. Keep this drug out of reach of children.
Nimodipine Interactions with Other Drugs
The use of nimodipine with certain drugs can cause interactions between drugs, such as:
- Increased risk of developing severe hypotension when used with beta-blocking drugs, such as bisoprolol and atenolol
- Increased risk of developing severe hypotension when used with clarithromycin , ritonavir, ketoconazole , alprazolam, or nefazodone
- Increased blood levels of nimodipine when used with the drugs cimetidine or sodium valporate
- Decreased levels and effectiveness of nimodipine when used with rifampicin , phenobarbital, carbamazepine , and phenytoin
- Increased risk of developing hypertension when used with NSAIDs , such as mefenamic acid or ibuprofen
If taken with grapefruit , nimodipine blood levels can increase and cause side effects. Meanwhile, the use of herbal products containing St. St. John's wort may decrease the levels and effectiveness of nimodipine.
Nimodipine Side Effects and Dangers
Side effects that may arise after using nimodipine are:
- Stomach ache
- Redness and warmth on the skin ( flushing )
- Muscle ache
- Sweat a lot
Check with your doctor if the side effects above don't go away or get worse. Immediately see a doctor if you experience a drug allergic reaction or serious side effects, such as:
- Slow, too fast, or irregular heartbeat
- Swelling in the legs or feet
- Chest pain
- Hard to breathe
- Blurred vision
- Can't have a bowel movement for more than 3 days