Nimodipine

1 medicine

Nimodipine is a calcium channel blocker used after a brain aneurysm bleed (subarachnoid haemorrhage) to protect brain function. It must only be given by mouth: injecting it directly into a vein has caused fatal cardiac arrest.

Nimotop

Nimodipine

30mg

Nimotop is a heart blood pressure medication containing Nimodipine, available as 30mg tablets.

from $1.01 / tablet View

Key facts

  • Nimodipine (sold as Nimotop) is a calcium channel blocker that acts mainly on blood vessels in the brain. It is used after a subarachnoid haemorrhage, bleeding around the brain usually from a ruptured aneurysm, to reduce the risk of stroke-like damage from delayed vessel spasm.
  • It is taken as capsules or oral liquid, 60 mg every 4 hours for 21 days, started within 4 days of the bleed.
  • Nimodipine must be given by mouth or feeding tube only. Injecting it into a vein, even by accident through IV tubing, has caused cardiac arrest and death within minutes.
  • Seek urgent care for a sudden faint, very slow heartbeat, or severe drop in blood pressure.

What nimodipine treats

Nimodipine treats the aftermath of aneurysmal subarachnoid haemorrhage. Doctors give it to eligible patients after this type of bleed to lower the chance of the delayed brain injury that vessel narrowing (vasospasm) can cause in the following weeks. It is not used for everyday high blood pressure or chest pain, and other calcium channel blockers are not interchangeable with it for this purpose.

How nimodipine works

Nimodipine blocks calcium from entering the smooth muscle cells of blood vessels, particularly those supplying the brain, which it reaches more readily than other calcium channel blockers. This keeps the vessels relaxed and appears to protect brain cells during the period after a bleed when vessels are prone to spasm, even though the exact protective mechanism is still debated.

Before you take it

  • Nimodipine is given only under medical supervision in hospital, usually starting soon after a confirmed subarachnoid haemorrhage.
  • Tell the care team about liver disease, since doses may need to be lowered.
  • Strong interactions exist with drugs that change how the liver clears nimodipine: azole antifungals, some HIV medicines, and macrolide antibiotics can raise levels and cause dangerous low blood pressure, while rifampin, phenytoin, carbamazepine, and St John's wort can lower levels and blunt its effect.
  • Grapefruit juice can raise nimodipine levels and should be avoided.

Side effects

Common effects include low blood pressure, headache, flushing, dizziness on standing, and nausea.

Stop and seek urgent medical care for any of these:

  • Fainting or a severe drop in blood pressure.
  • A very slow, fast, or irregular heartbeat.
  • Signs of an allergic reaction: rash, facial swelling, or difficulty breathing.

Safety essentials

  • Nimodipine capsules and oral liquid are for enteral use only, by mouth or feeding tube. Never connect a syringe of nimodipine to an IV line: intravenous administration has caused fatal cardiac arrest, severe hypotension, and heart block, sometimes within minutes.
  • If a feeding tube is used, the capsule is punctured and the liquid is drawn out and given through the tube; the empty capsule shell is then discarded, and the tube must never be connected to an IV line.
  • Blood pressure is monitored closely during the 21-day course, especially when treatment starts or the dose changes.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.