Nimodipine is chemically a calcium antagonist - a 1,4-dihydropyridine derivative. It belongs to the second generation of calcium channel blockers. What are the indications and contraindications for the use of nimodipine? What are the side effects of nimodipine?

Nimodipinehas one, most important task - to inhibit the influx of calcium ions to the smooth muscle cells and thus inhibit the contraction of the muscles that build the walls of blood vessels. Thanks to its action - it prevents the narrowing of cerebral vessels and (very importantly) ischemia of the brain tissue.

Nimodipina - indications for use

Nimodipine is a substance quite often used both in the prophylaxis and in the treatment of neurological deficits caused by ischemia caused by cerebral vasospasm, especially due to subarachnoid hemorrhage caused by aneurysm rupture. It can also prevent or eliminate vasoconstriction caused by other substances such as serotonin, prostaglandins or histamine.

According to research, nimodipine also protects neurons (i.e. nerve cells) and stabilizes their functions. Therefore, it is believed that this drug can also be used to treat changes in the brain simply resulting from aging. It would endure such changes as memory impairment, impaired concentration, changing behavior, emotional lability or decreased mental capacity.

Nomodipine - contraindications

The main contraindication is hypersensitivity to nimodipine itself or other ingredients of the preparation.
And when should you be especially careful with nimodipine?

  • in patients with generalized cerebral edema and a significant increase in intracranial pressure
  • in patients with significantly lowered blood pressure
  • and in patients with unstable angina, as well as in patients who have had an acute myocardial infarction

Nimodipine and pregnancy and lactation

If the preparation must be administered to a pregnant woman, the general condition of the patient should be taken into account, a reliable diagnosis should be carried out, and all the risks associated with it should be considered. As a general rule, this medicine should not be used during pregnancy as it relaxes the muscles of the womb and may prolongchildbirth, which may endanger the baby.

It should also not be used during breastfeeding. Nimodipine and its metabolites are excreted in breast milk in a concentration practically equal to that in the mother's serum - it is recommended to stop breastfeeding during treatment with nimodipine.

Nimopidin side effects

Like all drugs, nimodipine can also cause side effects. It should be remembered that not everyone will experience them, and their intensity may also be different.

Uncommon side effects include:

  • allergic reactions
  • rash
  • headache
  • tachycardia
  • hypotension
  • vasodilation
  • feeling sick

Rarely:

  • bradycardia
  • intestinal obstruction
  • transient increase in liver enzymes
  • infusion or injection site reactions
  • Thrombophlebitis at the infusion site

Interactions of nimodipine with other drugs

Before starting treatment with nimodipine, tell your doctor about all medications you are taking, including herbal and over-the-counter medications, because:

  • simultaneous administration of nimodipine and fluoxetine increases the concentration of the former in the blood serum, which may increase the likelihood of side effects
  • simultaneous administration of nimodipine may increase the hypotensive effect of antihypertensive drugs - e.g. diuretics, other calcium channel inhibitors, drugs blocking alpha-adrenergic receptors. If it is necessary to use nimodipine in combination with the above-mentioned drugs, the patient's condition should be monitored systematically
  • administration of the preparation with drugs that may have nephrotoxic effects (aminoglycoside antibiotics, cephalosporins, furosemide) may increase the adverse effect on renal function, especially in patients with renal insufficiency. In these cases, the parameters of renal function should be constantly monitored, and in the event of symptoms of renal failure, discontinuation of treatment or reduction of the dose of the drug should be considered

Nimodipina and citrus

Grapefruits, as probably everyone knows, have many properties that are beneficial to he alth. Like most citrus fruits, they positively affect our immunity, lower cholesterol and blood pressure, support slimming the body by accelerating metabolism and facilitate fat burning.

However, it should be remembered that they contain certain compounds, namely: flavonoids and phenylcoumarins, which, like some drugs,are metabolized by the same group of cytochrome P450 isoenzymes. This means that when you consume grapefruit or grapefruit juice and the drug at the same time, they are blocked by the compounds contained in the juice, making the drug metabolism impossible, or at least very limited. As a consequence of this, the concentration of the drug in the body increases dangerously, causing a number of undesirable effects.

To avoid interactions, do not drink grapefruit juice or eat grapefruit at least 4 hours before and 4 hours after taking the drug. Therefore, it is generally accepted that both nimodipine and other medications should be washed down with water.

Taking more than the recommended dose of the drug - nimodipine poisoning

Acute overdose with nimodipine results in poisoning the body. The symptoms of poisoning include:

  • heart rhythm disturbance
  • significant reduction in blood pressure
  • nausea
  • gastrointestinal complaints

In the event of overdose, stop taking the drug immediately. Unfortunately, in such a situation it may be necessary to perform gastric lavage and administration of activated charcoal, and if the blood pressure drops, it may be necessary to administer intravenous dopamine or noradrenaline. Therefore, it is important that such a patient is under the professional care of a doctor as soon as possible.

Warning!

It is very important to exercise caution when using this medication. That is why it is so important that the patient does not change the dose prescribed by the doctor himself, does not interfere with the manner of administration and under no circumstances passes this medicine on to another person! It should also be remembered that in-depth diagnosis is especially important when the patient has other comorbidities, e.g. congestive heart failure, recent heart attack, decreased heart rate, liver disease, hypertension or low blood pressure.

About the authorKarolina NowakA pharmaceutical technician by education. Currently, he is professionally fulfilled working in a pharmacy. Empathetic, sensitive and fond of contact with other people. Privately, a lover of a good book.

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