NIMODIPINE

(Generic Name)

BRAND NAME

Nimotop

TYPE OF DRUG

Calcium channel blocker.

PRESCRIBED FOR

Functional losses following a stroke. Nimodipine may also be prescribed for migraine

and cluster headaches.

GENERAL INFORMATION

Nimodipine is one of several calcium channel blockers available in the United States.

Unlike the other members of this group, Nimodipine has a negligible effect on the

heart. It is unique because it is the only calcium channel blocker proven effective as a

drug to help improve neurological function after a stroke. Calcium channel blockers

work by slowing the passage of calcium into cells. This causes muscles in the blood

vessels that supply your heart and other tissues to open wider, allowing more blood to

flow through them. They also decrease muscle spasm in those blood vessels.

Nimodipine readily dissolves in fatty tissues and reaches very high concentrations in

the brain and spinal fluid. Because of this, it has a greater effect on blood vessels in the

brain than on those in other parts of the body. Nimodipine relieves stroke symptoms

but does not reduce spasms in brain blood vessels. A great deal of research still needs

to be done to discover exactly how this drug works.

CAUTIONS AND WARNINGS

Nimodipine should not be taken if you are sensitive or allergic to it or if you have a

condition called aortic stenosis, in which the aorta becomes stiffer and less flexible

than normal. Animals given Nimodipine developed a high rate of testicular and uterine

cancer. It is not known if the drug has this effect on humans.

Liver disease, including cirrhosis, may slow the break-down of Nimodipine by the

body. This can produce a need to take a lower than normal dose of the drug.

PREGNANCY/BREAST-FEEDING

Animal studies have shown that Nimodipine can cause malformation of a fetus. Very

high doses can cause poor fetal growth, death of the fetus, and fetal bone problems.

Nimodipine should be avoided by pregnant women or women who may become

pregnant while using it. In situations where the drug is deemed essential by your

doctor, the potential risk of the drug must be carefully weighed against any benefit it

might produce.

Nimodipine has been shown, in animal studies, to pass into breast milk. Women who

must use Nimodipine should use an alternative feeding method.

SENIORS

Older adults, especially those with severe liver disease, may be more sensitive to the

side effects of Nimodipine.

POSSIBLE SIDE EFFECTS

The most common side effects of Nimodipine are diarrhea and headache.

Less common side effects include swelling of the arms or legs, changes in blood

pressure (low or high), heart failure, rapid heartbeat, changes in the electrocardiogram,

depression, memory loss, psychosis, paranoid feelings, hallucinations, nausea, itching,

acne, rash, anemia, bleeding or bruising, abnormal blood clotting, flushing, breathing

difficulty, stomach bleeding, and muscle cramps.

Rare side effects include dizziness, heart attack, liver inflammation or jaundice,

vomiting, and sexual difficulties.

DRUG INTERACTIONS

Calcium channel blockers may cause bleeding when taken alone or together with

Aspirin.

Cimetidine may increase the effects of Nimodipine by decreasing the rate at which

Nimodipine is broken down by the liver.

Taking Nimodipine together with a beta-blocking drug is usually well-tolerated but

may lead to heart failure in susceptible people.

Calcium channel blockers, including Nimodipine, may add to the effects of Digoxin,

although this effect is not observed with any consistency and only affects people with

a large amount of Digoxin already in their system.

FOOD INTERACTIONS

Nimodipine is best taken on an empty stomach--at least 1 hour before or 2 hours after

meals--but may be taken with food or milk if it upsets your stomach.

USUAL DOSE

60 milligrams 4 times a day beginning within 96 hours after the stroke and continuing

for 21 days.

OVERDOSAGE

The major symptoms of Nimodipine overdose are nausea, weakness, dizziness,

drowsiness, confusion, and slurred speech. Blood pressure and heart rate may also be

affected. Nimodipine can be removed from a victim's stomach by giving Syrup of

Ipecac to induce vomiting, but this should be done only under a doctor's supervision or

direction. Once symptoms develop, the victim must be taken to a hospital emergency

room for treatment.

SPECIAL INFORMATION

Call your doctor if you develop any of the following symptoms: swelling of the arms or

legs, breathing difficulty, severe dizziness, constipation, or nausea.

Patients who are unable to swallow Nimodipine capsules because of their condition

may have the liquid withdrawn from the capsule with a syringe and mixed with other

liquids to be given orally or through a feeding tube.

If you forget to take a dose of Nimodipine, take it as soon as you remember. If it is

almost time for your next dose, skip the forgotten dose and continue with your regular

schedule. Call your doctor if you miss more than 2 doses.