Adult Dosing

Subarachnoid hemorrhage

• 60 mg PO q4 hrs x 21 days
• Start therapy within 96 hrs; give 1 hr before or 2 hrs after meals. Can give capsule contents SL or via nasogastric tube

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Indicated for the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in patients with subarachnoid hemorrhage

• Hypersensitivity to any of the ingredients of the product
• Parenteral use

nimodipine (generic)

• Deaths and serious life-threatening adverse events have been reported with parenteral injection of capsule contents. Therefore do not give IV or by other parenteral routes

Renal Dose Adjustment

• Renal impairment: No dose adjustments

Hepatic Dose Adjustment

• Hepatic cirrhosis: 30 mg PO q4 hrs; closely monitor BP and HR

See Supplemental Patient Information

• Do not give IV or by other parenteral routes; death and serious life-threatening adverse events have been reported with parenteral injection of capsule contents [US Black Box Warning]
• Monitor hepatic function; HR and BP as the metabolism of nimodipine is decreased in patients with impaired hepatic function
• Do not administer IV; if inadvertent IV administration occurs, clinically significant hypotension may require cardiovascular support with pressor agents

Cautions: Use cautiously in

• Hepatic impairment
• Geriatric population
• Lactating women

Supplemental Patient Information

• Should not drink alcohol while on this medication
• Sudden discontinuation is not advised

Nimotop, Nymalize interacts with :

	Agenerase
	Akne-mycin
	Amiodarone
	Amprenavir
	Aprepitant
	Atazanavir
	Barbiturates
	Biaxin
	Biaxin XL
	Boceprevir
	Bosentan
	Carbamazepine
	Carbatrol
	Ceritinib
	Cetraxal
	Ciloxan
	Cipro
	Cipro IV
	Cipro XR
	Ciprofloxacin
	Clarithromycin
	Cloxacillin
	Cloxapen
	Cobicistat
	Conivaptan
	Cordarone
	Crixivan
	Cyclosporine
	Dabrafenib
	Darunavir
	Delavirdine
	Dicloxacillin
	Diflucan
	Dilantin
	Dilantin Infatabs
	Dilantin-125
	Dronedarone
	Dynapen
	E-Mycin
	E.E.S.
	Emend
	Epitol
	Equetro
	Ery-Tab
	Eryc
	Erygel
	Eryped
	Erythra-Derm
	Erythro-statin
	Erythrocin
	Erythromycin
	Extina
	Fluconazole
	Fluvoxamine
	Gengraf
	Grapefruit
	Grifulvin V
	Gris-Peg
	Grisactin
	Griseofulvin
	Incivek
	Indinavir
	Invirase
	Itraconazole
	Juxtapid
	Ketek
	Ketoconazole
	Korlym
	Lomitapide
	Luvox
	Luvox CR
	Mifepristone
	Multaq
	Mycobutin
	Mysoline
	Nafcillin
	Nallpen
	Nefazodone
	Nelfinavir
	Neoral
	Nexterone
	Nizoral
	Nizoral A-D Shampoo
	Nizoral Shampoo
	Norvir
	Noxafil
	Onmel
	Oxcarbazepine
	Oxtellar XR
	Pacerone
	PCE
	Pediamycin
	Phenytek
	Phenytoin
	Posaconazole
	Prezista
	Priftin
	Primidone
	Proquin XR
	Quinupristin
	Rescriptor
	Restasis
	Reyataz
	Rifabutin
	Rifadin
	Rifampin
	Rifapentine
	Rimactane
	Ritonavir
	Sandimmune
	Saquinavir
	Sporanox
	St. John's Wort
	Stribild
	Synercid
	Tafinlar
	TAO
	Tegretol
	Tegretol XR
	Telaprevir
	Telithromycin
	Teril
	Tracleer
	Trileptal
	Troleandomycin
	Unipen
	Vaprisol
	Vfend
	Victrelis
	Viracept
	Voriconazole
	Xolegel
	Zykadia

Pregnancy Category:C

Breastfeeding: Safety unknown; limited data indiactes that amounts ingested by the infant are small and would not be expected to cause any adverse effects. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 24 March 2011). Nimodipine is excreted in breastmilk of lactating animals. Manufacturer recommends discontinuation of breastfeeding during therapy.

• CNS: Abnormal dreams, anxiety, confusion, dizziness, drowsiness, headache, nervousness, psychiatric disturbances, weakness
• NEURO: Paresthesia, tremor
• EENT: Blurred vision, disturbed equilibrium, epistaxis, tinnitus
• RESP: Cough, dyspnea
• CV: Decreased blood pressure, arrhythmias, CHF, bradycardia, chest pain, palpitations, peripheral edema, syncope, tachycardia, AV conduction abnormalities, thromboembolism, edema, bradycardia
• GI: Liver enzymes, anorexia, constipation, diarrhea, dry mouth, dysgeusia, dyspepsia, nausea, vomiting, GI bleed, ileus, intestinal obstruction
• HEPA: Hepatitis, elevated LFTs
• GU: Dysuria, nocturia, polyuria, sexual dysfunction, urinary frequency
• DERM: Dermatitis, erythema multiforme, flushing, increased sweating, photosensitivity, pruritus/urticaria, rash
• ENDO: Gynecomastia, hyperglycemia
• HEMA: Anemia, leukopenia, thrombocytopenia
• METABOLIC: Weight gain
• MUSC: Joint stiffness, muscle cramps
• MISC: Stevens-Johnson syndrome, gingival hyperplasia

• Calcium channel blocker; inhibits the transport of calcium into vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction
• Well absorbed following oral administration
• Extensively metabolized by liver; CYP450: 3A4 substrate
• Renally excreted (<1% unchanged)
• Half-life: 8-9 hrs; rapid early elimination rates necessitate frequent dosing (half-life: 1-2 hrs)

US Trade Name(s)

• Nymalize

US Availability

nimodipine (generic)

• CAPS: 30 mg

Nymalize

• SOLN: 60 mg/20 ml

Canadian Trade Name(s)

• Nimotop

Canadian Availability

Nimotop

• TABS: 30 mg

UK Trade Name(s)

• Nimotop

UK Availability

Nimotop

• TABS: 30 mg

Australian Trade Name(s)

• Nimotop

Australian Availability

Nimotop

• TABS: 30 mg

[Outline]

Cardiovascular

Calcium Channel Blockers

• Nimodipine 30 MG Oral Capsule (BARR LABORATORIES, INC.)
• Nimodipine 30 MG Oral Capsule (Caraco Pharmaceutical Laboratories, Ltd.)
• Nimodipine 30 MG Oral Capsule (Heritage)
• Nimotop 30 MG Oral Capsule (Bayer Pharmaceuticals Corporation)