Nimodipine 30mg Capsules

Nimodipine is a dihydropyridine calcium channel blocker that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and myocardial cells. It has a higher selectivity for cerebral blood vessels, preventing or reversing vasospasm following subarachnoid hemorrhage (SAH) by relaxing cerebral vascular smooth muscle.

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Severe dizziness or fainting
Slow heartbeat
Abnormal heartbeat
Shortness of breath
Sudden significant weight gain
Swelling in the arms or legs

Other Possible Side Effects

Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.

Please note that this list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor.

Reporting Side Effects

To report side effects, you can:

Call your doctor for medical advice
Contact the FDA at 1-800-332-1088
Visit the FDA's MedWatch website at https://www.fda.gov/medwatch to report side effects online.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances. Be sure to describe the allergic reaction you experienced, including the symptoms that occurred.
Any medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial because certain medications, such as those used to treat HIV, infections, depression, and other conditions, may interact with this drug and should not be taken concurrently. Your doctor or pharmacist can provide guidance on potential interactions.
* Please note that this is not an exhaustive list of all medications or health conditions that may interact with this drug.

To ensure your safety, it is vital to discuss all of your medications (prescription and OTC), natural products, vitamins, and health problems with your doctor and pharmacist. This will help determine whether it is safe to take this medication in conjunction with your other medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

When starting this medication, be cautious when engaging in activities that require your full attention, such as driving, until you understand how it affects you. To minimize the risk of dizziness or fainting, get up slowly from a sitting or lying position. Be particularly careful when navigating stairs.

Follow your healthcare provider's instructions for monitoring your blood pressure. Additionally, avoid consuming grapefruit and grapefruit juice while taking this medication.

If you are pregnant, planning to become pregnant, or are breastfeeding, consult your doctor to discuss the potential benefits and risks of this medication to both you and your baby.

• Strong CYP3A4 inducers (e.g., rifampin, phenobarbital, phenytoin, carbamazepine) due to significant reduction in nimodipine plasma concentrations and loss of efficacy.

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, voriconazole, clarithromycin, erythromycin, telithromycin, ritonavir, indinavir, nelfinavir, saquinavir) due to increased nimodipine plasma concentrations and risk of hypotension.
• Other antihypertensive agents (e.g., beta-blockers, diuretics, ACE inhibitors) due to additive hypotensive effects.

• Moderate CYP3A4 inhibitors (e.g., diltiazem, verapamil, fluconazole, grapefruit juice) due to increased nimodipine plasma concentrations.
• Cimetidine, valproic acid (may increase nimodipine levels).

• Not available

• Headache
• Dizziness
• Lightheadedness
• Flushing
• Nausea
• Edema
• Bradycardia
• Hypotension (symptoms like fainting, weakness)
• Signs of worsening neurological function (e.g., confusion, weakness, speech difficulties)

Nimodipine is Pregnancy Category C. Animal studies have shown adverse effects on the fetus, but there are no adequate and well-controlled studies in pregnant women. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nimodipine is excreted in human milk. Due to the potential for serious adverse reactions in the breastfed infant, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Safety and effectiveness in pediatric patients have not been established. Use is generally not recommended.

Elderly patients may have increased bioavailability of nimodipine and may be more sensitive to its hypotensive effects. Close monitoring of blood pressure is recommended, and a lower starting dose (e.g., 30 mg every 4 hours) may be considered, especially in those with hepatic impairment.

• Nimodipine is highly specific for cerebral vasculature and is the only calcium channel blocker indicated for improving neurological outcome and reducing mortality in patients with subarachnoid hemorrhage (SAH).
• It is crucial to administer nimodipine orally. Accidental intravenous administration of oral nimodipine has led to severe adverse events, including death, due to profound hypotension and cardiovascular collapse.
• Always check for drug interactions, especially with CYP3A4 inhibitors (e.g., azole antifungals, macrolides, grapefruit juice) and inducers (e.g., rifampin, anticonvulsants), as these can significantly alter nimodipine levels.
• Patients should be monitored closely for hypotension, especially at the initiation of therapy or with dose adjustments.
• Ensure patients swallow the capsules whole; do not crush, chew, or open them.
• The full 21-day course of therapy is important for optimal benefit, even if the patient's neurological status improves.

• Other calcium channel blockers (e.g., nicardipine, verapamil) are not indicated for the specific purpose of preventing vasospasm after SAH.
• Endovascular therapies (e.g., angioplasty, intra-arterial vasodilators) may be used to treat established cerebral vasospasm, but not as prophylaxis in place of nimodipine.

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.