Nimodipine: Drug information

(For additional information see "Nimodipine: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)

ALERT: US Boxed Warning

Inadvertent intravenous administration:

Do not administer nimodipine intravenously (IV) or by other parenteral routes. Deaths and serious, life-threatening adverse reactions have occurred when the contents of nimodipine capsules have been injected parenterally.

Brand Names: US

Nymalize

Brand Names: Canada

Nimotop

Pharmacologic Category

Calcium Channel Blocker;
Calcium Channel Blocker, Dihydropyridine

Dosing: Adult

Note: For enteral administration ONLY. Nimodipine oral solution (3 mg/mL) has been discontinued in the United States for >1 year.

Subarachnoid hemorrhage

Subarachnoid hemorrhage: Oral: 60 mg every 4 hours for 21 consecutive days. Note: Start therapy within 96 hours of the onset of subarachnoid hemorrhage.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

No dosage adjustment provided in manufacturer's labeling. However, nimodipine undergoes minimal renal elimination and dose adjustment may not be necessary. Not removed by hemo- or peritoneal dialysis; supplemental dose is not necessary.

Dosing: Hepatic Impairment: Adult

Cirrhosis: 30 mg every 4 hours for 21 consecutive days.

Dosing: Adjustment for Toxicity: Adult

Hypotension:

Note: Optimal management is not clearly defined (Ref).

May consider halving dose and administering more frequently (eg, 30 mg every 2 hours); discontinuation of therapy may be necessary if hypotension persists (Ref).

Dosing: Older Adult

Refer to adult dosing; use with caution.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%:

Cardiovascular: Decreased blood pressure (4% to 5%), bradycardia (1%)

Central nervous system: Headache (1%)

Gastrointestinal: Nausea (1%)

<1%, postmarketing, and/or case reports: Anemia, decreased platelet count, diaphoresis, disseminated intravascular coagulation, dizziness, edema, flushing, gastrointestinal hemorrhage, gastrointestinal pseudo-obstruction, hematoma, hepatitis, hypertension, increased lactate dehydrogenase, increased serum alkaline phosphatase, increased serum ALT, increased serum glucose, intestinal obstruction, jaundice, muscle cramps, palpitations, pruritus, psoriasis (Song 2021), rebound vasospasm, thrombocytopenia, vomiting, wheezing

Contraindications

US labeling:

Concomitant use with strong CYP3A4 inhibitors (eg, clarithromycin, telithromycin, delavirdine, indinavir, nelfinavir, ritonavir, saquinavir, ketoconazole, itraconazole, voriconazole, and nefazodone).

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Nymalize: There are no contraindications listed in the manufacturer’s labeling.

Canadian labeling: Hypersensitivity to nimodipine or any component of the formulation; concomitant use with phenobarbital, phenytoin, carbamazepine, or rifampin

Warnings/Precautions

Concerns related to adverse effects:

• Angina/MI: Increased angina and/or MI have occurred with initiation or dosage titration of dihydropyridine calcium channel blockers. Reflex tachycardia may occur resulting in angina and/or MI in patients with obstructive coronary disease, especially in the absence of concurrent beta-blockade.

• Hypotension/syncope: Symptomatic hypotension with or without syncope can occur; blood pressure must be lowered at a rate appropriate for the patient's clinical condition. Monitor blood pressure closely during treatment.

Disease-related concerns:

• Hepatic impairment: Use with caution in patients with cirrhosis due to the increased plasma concentrations of nimodipine and an increased risk of adverse reactions; a lower dose and close monitoring of blood pressure and heart rate are required.

• Hypertrophic cardiomyopathy with outflow tract obstruction: Use with caution in patients with hypertrophic cardiomyopathy with outflow tract obstruction.

Other warnings/precautions:

• Inadvertent IV administration: When inadvertently administered IV, fatality may occur; precautions (eg, adequate labeling, use of oral syringes) should be employed against such an event.

Product Availability

Nimodipine oral solution (3 mg/mL) has been discontinued in the United States for >1 year.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Generic: 30 mg

Solution, Oral:

Nymalize: 30 mg/10 mL (10 mL [DSC]); 60 mg/20 mL (20 mL [DSC], 473 mL [DSC]); 6 mg/mL (5 mL, 10 mL, 237 mL) [contains alcohol, usp, methylparaben, polyethylene glycol (macrogol)]

Generic Equivalent Available: US

May be product dependent

Pricing: US

Capsules (niMODipine Oral)

30 mg (per each): $19.23

Solution (Nymalize Oral)

6 mg/mL (per mL): $11.76

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Nimotop: 30 mg

Administration: Adult

For enteral administration ONLY. Life-threatening adverse events have occurred when administered parenterally.

Oral:

US labeling: Administer at least 1 hour before or 2 hours after meals.

Canadian labeling: Administer without regards to meals; but administer consistently either with or without meals. Tablet should be swallowed whole with an adequate amount of fluid (eg, glass of water). Do not crush tablet. Avoid alkaline mixtures for 2 hours before or after administration. Patient should not be lying down during administration.

NG or gastric tube administration:

Oral solution (Nymalize): Note: Administer at least 1 hour before or 2 hours after meals. Oral solution is available as a 3 mg/mL concentration supplied in a bulk bottle or unit-dose cup or as a 6 mg/mL concentration supplied in a bulk bottle or prefilled oral syringe.

3 mg/mL concentration (bulk bottle or unit-dose cup): Administer using the supplied oral syringe labeled "ORAL USE ONLY." Following administration, refill the oral syringe with 20 mL of NS and flush any remaining contents from NG or gastric tube into the stomach.

6 mg/mL concentration (bulk bottle or prefilled oral syringe): Following administration, refill oral syringe with 10 mL of NS and flush any remaining contents from NG or gastric tube into the stomach.

Capsules: Administer at least 1 hour before or 2 hours after meals. If the capsules cannot be swallowed, the liquid may be removed by making a hole in each end of the capsule with an 18-gauge needle and extracting the contents into a syringe; transfer these contents into an oral syringe (amber-colored oral syringe preferred for storage). It is strongly recommended that preparation be done in the pharmacy. Label oral syringe with "WARNING: For ORAL use only” or “Not for IV use” (Ref). Follow administration with a flush of 30 mL NS.

Use: Labeled Indications

Subarachnoid hemorrhage: For the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in adult patients with subarachnoid hemorrhage from ruptured intracranial aneurysms regardless of post-ictus neurological condition (ie, Hunt and Hess grades I to V) (AHA/ASA [Hoh 2023]; NCS [Treggiari 2023]; manufacturer’s labeling).

Medication Safety Issues

Sound-alike/look-alike issues:

NiMODipine may be confused with niCARdipine, NIFEdipine, nisoldipine

Administration issues:

Inadvertent intravenous administration; For patients unable to swallow a capsule, the drug should be dispensed in an oral syringe (preferably amber in color) labeled "WARNING: For ORAL use only" or "Not for IV use." Nimodipine has inadvertently been administered IV when withdrawn from capsules into a syringe for subsequent nasogastric tube administration. Severe cardiovascular adverse events, including fatalities, have resulted. Employ precautions against such an event.

Metabolism/Transport Effects

Substrate of CYP3A4 (major); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider therapy modification

Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arginine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Atosiban: Calcium Channel Blockers may enhance the adverse/toxic effect of Atosiban. Specifically, there may be an increased risk for pulmonary edema and/or dyspnea. Risk C: Monitor therapy

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Brigatinib: May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

Calcium Salts: May diminish the therapeutic effect of Calcium Channel Blockers. Risk C: Monitor therapy

Cimetidine: May increase the serum concentration of Calcium Channel Blockers. Risk C: Monitor therapy

Cladribine: Inhibitors of Equilibrative Nucleoside (ENT1) and Concentrative Nucleoside (CNT3) Transport Proteins may increase the serum concentration of Cladribine. Management: Avoid concomitant use of ENT1 or CNT3 inhibitors during the 4 to 5 day oral cladribine treatment cycles whenever possible. If combined, consider an ENT1 or CNT3 inhibitor dose reduction and separation in the timing of administration. Risk D: Consider therapy modification

Clofazimine: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

Clopidogrel: Calcium Channel Blockers may diminish the therapeutic effect of Clopidogrel. Risk C: Monitor therapy

CycloSPORINE (Systemic): Calcium Channel Blockers (Dihydropyridine) may increase the serum concentration of CycloSPORINE (Systemic). CycloSPORINE (Systemic) may increase the serum concentration of Calcium Channel Blockers (Dihydropyridine). Risk C: Monitor therapy

CYP3A4 Inducers (Moderate): May decrease the serum concentration of NiMODipine. Risk C: Monitor therapy

CYP3A4 Inducers (Strong): May decrease the serum concentration of NiMODipine. Risk X: Avoid combination

CYP3A4 Inducers (Weak): May decrease the serum concentration of NiMODipine. Risk C: Monitor therapy

CYP3A4 Inhibitors (Moderate): May increase the serum concentration of NiMODipine. Risk C: Monitor therapy

CYP3A4 Inhibitors (Strong): May increase the serum concentration of NiMODipine. Risk X: Avoid combination

CYP3A4 Inhibitors (Weak): May increase the serum concentration of NiMODipine. Risk C: Monitor therapy

Dantrolene: May enhance the hyperkalemic effect of Calcium Channel Blockers. Dantrolene may enhance the negative inotropic effect of Calcium Channel Blockers. Risk X: Avoid combination

Dapoxetine: May enhance the orthostatic hypotensive effect of Calcium Channel Blockers. Risk C: Monitor therapy

Dexmethylphenidate: May diminish the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Fexinidazole: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk X: Avoid combination

Flunarizine: May enhance the therapeutic effect of Antihypertensive Agents. Risk C: Monitor therapy

FLUoxetine: May increase the serum concentration of NiMODipine. Risk C: Monitor therapy

Fusidic Acid (Systemic): May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk X: Avoid combination

Grapefruit Juice: May increase the serum concentration of NiMODipine. Risk X: Avoid combination

Herbal Products with Blood Pressure Increasing Effects: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Indoramin: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Inhalational Anesthetics: May enhance the hypotensive effect of Calcium Channel Blockers. Risk C: Monitor therapy

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Foslevodopa. Risk C: Monitor therapy

Loop Diuretics: May enhance the hypotensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Magnesium Sulfate: May enhance the adverse/toxic effect of Calcium Channel Blockers (Dihydropyridine). Specifically, the risk of hypotension or muscle weakness may be increased. Risk C: Monitor therapy

Melatonin: May diminish the antihypertensive effect of Calcium Channel Blockers (Dihydropyridine). Risk C: Monitor therapy

Methylphenidate: May diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Neuromuscular-Blocking Agents (Nondepolarizing): Calcium Channel Blockers may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents (Nondepolarizing). Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider therapy modification

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Prazosin: Antihypertensive Agents may enhance the hypotensive effect of Prazosin. Risk C: Monitor therapy

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Silodosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Sincalide: Drugs that Affect Gallbladder Function may diminish the therapeutic effect of Sincalide. Management: Consider discontinuing drugs that may affect gallbladder motility prior to the use of sincalide to stimulate gallbladder contraction. Risk D: Consider therapy modification

St John's Wort: May decrease the serum concentration of NiMODipine. Risk X: Avoid combination

Tacrolimus (Systemic): Calcium Channel Blockers (Dihydropyridine) may increase the serum concentration of Tacrolimus (Systemic). Risk C: Monitor therapy

Terazosin: Antihypertensive Agents may enhance the hypotensive effect of Terazosin. Risk C: Monitor therapy

Urapidil: Antihypertensive Agents may enhance the hypotensive effect of Urapidil. Risk C: Monitor therapy

Food Interactions

Administration of capsules with a standard breakfast results in a 68% lower maximum plasma concentration and 38% lower bioavailability as compared to administration under fasted conditions. In addition, AUC and maximum plasma concentration were increased by an average of 51% and 24%, respectively, following administration of nimodipine with grapefruit juice (Fuhr 1998). Management: Administer capsules on an empty stomach, at least 1 hour before or 2 hours after meals. Avoid concurrent use of grapefruit juice and nimodipine capsules or tablets [Canadian product].

Pregnancy Considerations

Nimodipine crosses the placenta (Belfort 1994).

Fetal outcome data following maternal use of nimodipine during pregnancy are limited (Magee 1996; Weber-Schoendorfer 2008).

The management of subarachnoid hemorrhage in pregnant patients is generally managed the same as nonpregnant patients, considering the trimester at presentation. However, data describing use of nimodipine are limited and use should consider the fetal risks of maternal hypotension (Ascanio 2019; Beighley 2021; Fritzsche 2017; Robba 2016; Toossi 2019; Wilson 2005).

Nimodipine is known to cause cerebral vasodilation and hypotension, and therefore has been evaluated for the treatment of hypertension and prevention of seizures in patients with preeclampsia (Belfort 1994; Belfort 2003). However, nimodipine is not as effective as other agents in reducing high BP or reducing the risk of developing eclampsia and is not currently recommended for the management of preeclampsia (ACOG 2020; Duley 2013).

Breastfeeding Considerations

Nimodipine is present in breast milk (Carcas 1996; Tonks 1995).

Data related to the presence of nimodipine in breast milk are available from 2 case reports. Oral nimodipine 60 mg every 4 hours for 10 days was administered to a woman ~3 days postpartum for the treatment of a subarachnoid hemorrhage. Breast milk and maternal serum were sampled every 3 hours for 24 hours, following 7 days of therapy. Although variable, nimodipine breast milk levels were approximately one-third of the maternal plasma concentrations. The highest breast milk concentration was ~3.5 ng/mL (Tonks 1995). Nimodipine was administered IV to a woman ~3 weeks postpartum as an infusion of 1 mg/hour over 2 hours, then 2 mg/hour up to 24 hours (total dose: 46 mg). The highest milk concentration (4.7 ng/mL) occurred ~2 hours after the infusion was completed. Authors of the study calculated the relative infant dose (RID) of nimodipine to be between 0.008% and 0.092% of the weight adjusted maternal dose, providing an estimated daily infant dose via breast milk of 0.063 and 0.705 mcg/kg/day (Carcas 1996). In general, breastfeeding is considered acceptable when the RID of a medication is <10% (Anderson 2016; Ito 2000).

According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother.

Monitoring Parameters

BP and heart rate.

Mechanism of Action

Nimodipine shares the pharmacology of other calcium channel blockers; animal studies indicate that nimodipine has a greater effect on cerebral arterials than other arterials; this increased specificity may be due to the drug's increased lipophilicity and cerebral distribution as compared to nifedipine; inhibits calcium ion from entering the “slow channels” or select voltage sensitive areas of vascular smooth muscle and myocardium during depolarization

Pharmacokinetics (Adult Data Unless Noted)

Protein binding: >95%.

Metabolism: Extensively hepatic via CYP3A4; undergoes first-pass metabolism.

Bioavailability: Capsule/oral solution: 13%; Tablet [Canadian product]: 16% (range: 3% to 30%).

Half-life elimination: 1 to 2 hours; prolonged with renal impairment.

Time to peak, serum: 0.25 to 1.05 hours.

Excretion: Urine (<1% as unchanged drug); feces.

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Hepatic function impairment: In patients with cirrhosis, bioavailability is increased and C_max almost doubles.

Older adult: AUC and C_max were ~2-fold higher in elderly patients compared with younger patients; this response is not considered clinically significant.

Brand Names: International

International Brand Names by Country

For country code abbreviations (show table)

(AE) United Arab Emirates: Nimotop;
(AR) Argentina: Nivas;
(AT) Austria: Nimotop;
(AU) Australia: Nimodipine juno | Nimotop;
(BE) Belgium: Nimotop;
(BG) Bulgaria: Dilceren | Nimotop S;
(BR) Brazil: Nimotop | Noodipina | Oxigen;
(CH) Switzerland: Nimotop;
(CL) Chile: Nimodipino | Nimotop | Regental;
(CN) China: Ai bang | Bei qing | Ji li | Mai dao tong | Mai te ling | Ni kang pu da | Ni li su | Nimotop | Ou Neng | Yi fu lin | You ni xin;
(CO) Colombia: Nimodipino | Nimotop | Nisom;
(CZ) Czech Republic: Dilceren | Nimotop S;
(DE) Germany: Nimodipin carino | Nimotop S;
(DO) Dominican Republic: Nimotop | Regental;
(EC) Ecuador: Nimotop | Vasoactin;
(EE) Estonia: Dilceren | Nimotop;
(EG) Egypt: Brainal | Nimotop;
(ES) Spain: Admon | Brainal | Nimodipino G.e.s. | Nimotop | Remontal;
(FI) Finland: Nimotop;
(FR) France: Nimotop;
(GB) United Kingdom: Nimotop;
(GR) Greece: Nimotop | Nimovac-V;
(HK) Hong Kong: Nimotop;
(HU) Hungary: Nimotop S;
(ID) Indonesia: Ceremax | Nimotop;
(IE) Ireland: Nimotop;
(IN) India: Modipin | Nimodec | Nimodip | Vasotop;
(IT) Italy: Nimotop | Periplum;
(JO) Jordan: Nimotop;
(KE) Kenya: Nimotop;
(KR) Korea, Republic of: Nimotop | Reyon nimodipine;
(KW) Kuwait: Nimotop;
(LB) Lebanon: Nimotop;
(LT) Lithuania: Dilceren | Nimodipin carino | Nimotax | Nimotop S;
(LV) Latvia: Dilceren | Nimotop S;
(MA) Morocco: Modine;
(MX) Mexico: Bre nidip | Derinex | Eugerial | Nimodipino | Nimodipino gi kend | Nimotop;
(MY) Malaysia: Nimotop;
(NL) Netherlands: Nimotop;
(NO) Norway: Nimotop;
(NZ) New Zealand: Nimotop;
(PE) Peru: Irrigor | Nimotop;
(PH) Philippines: Nimotop;
(PK) Pakistan: Bredin | Nimotop;
(PL) Poland: Nimotop S;
(PR) Puerto Rico: Nimotop;
(PT) Portugal: Modina | Nimodipina | Nimodipina Aps | Nimotop;
(PY) Paraguay: Irrigor | Modip | Modipin;
(RO) Romania: Dilceren;
(RU) Russian Federation: Dilceren | Nimodipine native | Nimopine | Nimotop;
(SA) Saudi Arabia: Nimotop;
(SE) Sweden: Nimotop;
(SG) Singapore: Nimotop;
(SI) Slovenia: Nimotop S;
(SK) Slovakia: Dilceren | Nimotop S;
(TH) Thailand: Nimotop;
(TN) Tunisia: Nimotop;
(TR) Turkey: Nimotop;
(TW) Taiwan: Nimotop;
(UA) Ukraine: Dilceren | Nimotop;
(UG) Uganda: Nimotop;
(UY) Uruguay: Inimod | Nimoion | Nimotop;
(VE) Venezuela, Bolivarian Republic of: Nimodipina | Nimotop | Tropocer;
(ZA) South Africa: Nimotop;
(ZW) Zimbabwe: Nimotop

American College of Obstetricians and Gynecologists (ACOG). Gestational hypertension and preeclampsia: ACOG practice bulletin, number 222. Obstet Gynecol. 2020;135(6):e237-e260. doi:10.1097/AOG.0000000000003891 [PubMed 32443079]
Anderson PO, Sauberan JB. Modeling drug passage into human milk. Clin Pharmacol Ther. 2016;100(1):42-52. doi:10.1002/cpt.377 [PubMed 27060684]
Ascanio LC, Maragkos GA, Young BC, Boone MD, Kasper EM. Spontaneous intracranial hemorrhage in pregnancy: a systematic review of the literature. Neurocrit Care. 2019;30(1):5-15. doi:10.1007/s12028-018-0501-4 [PubMed 29476390]
Beighley A, Glynn R, Scullen T, et al. Aneurysmal subarachnoid hemorrhage during pregnancy: a comprehensive and systematic review of the literature. Neurosurg Rev. 2021;44(5):2511-2522. doi:10.1007/s10143-020-01457-2 [PubMed 33409763]
Belfort MA, Anthony J, Saade GR, Allen JC Jr; Nimodipine Study Group. A comparison of magnesium sulfate and nimodipine for the prevention of eclampsia. N Engl J Med. 2003;348(4):304-311. doi:10.1056/NEJMoa021180 [PubMed 12540643]
Belfort MA, Saade GR, Moise KJ Jr, et al. Nimodipine in the management of preeclampsia: maternal and fetal effects. Am J Obstet Gynecol. 1994;171(2):417-424. doi:10.1016/0002-9378(94)90277-1 [PubMed 8059821]
Carcas AJ, Abad-Santos F, de Rosendo JM, et al. Nimodipine transfer into human breast milk and cerebrospinal fluid. Ann Pharmacother. 1996;30(2):148-150. doi:10.1177/106002809603000208 [PubMed 8835048]
Duley L, Meher S, Jones L. Drugs for treatment of very high blood pressure during pregnancy. Cochrane Database Syst Rev. 2013;2013(7):CD001449. doi:10.1002/14651858.CD001449.pub3 [PubMed 23900968]
Fritzsche FS, Regelsberger J, Schmidt NO, et al. Maternal aneurysmal subarachnoid hemorrhage during pregnancy as an interdisciplinary task. Z Geburtshilfe Neonatol. 2017;221(6):276-282. doi:10.1055/s-0043-119363 [PubMed 29041013]
Fuhr U, Maier-Brüggemann A, Blume H, et al, “Grapefruit Juice Increases Oral Nimodipine Bioavailability,” Int J Clin Pharmacol Ther, 1998, 36(3):126-32. [PubMed 9562227]
Funder JW, Carey RM, Mantero F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889-1916. doi: 10.1210/jc.2015-4061. [PubMed 26934393]
Green AE, Banks S, Jay M, Hatton J. Stability of nimodipine solution in oral syringes. Am J Health Syst Pharm. 2004;61(14):1493-1496. doi:10.1093/ajhp/61.14.1493 [PubMed 15332701]
Hoh BL, Ko NU, Amin-Hanjani S, et al. 2023 guideline for the management of patients with aneurysmal subarachnoid hemorrhage: a guideline from the American Heart Association/American Stroke Association. Stroke. 2023;54(7):e314-e370. doi:10.1161/STR.0000000000000436 [PubMed 37212182]
Ito S. Drug therapy for breast-feeding women. N Engl J Med. 2000;343(2):118-126. doi:10.1056/NEJM200007133430208 [PubMed 10891521]
Magee LA, Schick B, Donnenfeld AE, et al. The safety of calcium channel blockers in human pregnancy: a prospective, multicenter cohort study. Am J Obstet Gynecol. 1996;174(3):823-828. doi:10.1016/s0002-9378(96)70307-1 [PubMed 8633650]
Mahmoud SH, Hefny FR, Panos NG, et al. Comparison of nimodipine formulations and administration techniques via enteral feeding tubes in patients with aneurysmal subarachnoid hemorrhage: a multicenter retrospective cohort study. Pharmacotherapy. 2023;43(4):279-290. doi:10.1002/phar.2791 [PubMed 36880540]
Nimodipine [prescribing information]. East Brunswick, NJ: Avet Pharmaceuticals Inc; June 2020.
Nimotop (nimodipine) [product monograph]. Toronto, Ontario, Canada: Bayer Inc; November 2011.
Nymalize (nimodipine) [prescribing information]. Woburn, MA: Azurity Pharmaceuticals Inc; March 2023.
Nymalize (nimodipine) 6 mg solution [prescribing information]. Atlanta, GA: Arbor Pharmaceuticals LLC; May 2022.
Rabinstein AA, Lanzino G, Wijdicks EF. Multidisciplinary management and emerging therapeutic strategies in aneurysmal subarachnoid haemorrhage. Lancet Neurol. 2010;9(5):504-19. doi:10.1016/S1474-4422(10)70087-9 [PubMed 20398858]
Refer to manufacturer's labeling.
Robba C, Bacigaluppi S, Bragazzi NL, et al. Aneurysmal subarachnoid hemorrhage in pregnancy-case series, review, and pooled data analysis. World Neurosurg. 2016;88:383-398. doi:10.1016/j.wneu.2015.12.027 [PubMed 26724616]
Song G, Yoon HY, Yee J, Kim MG, Gwak HS. Antihypertensive drug use and psoriasis: a systematic review, meta- and network meta-analysis. Br J Clin Pharmacol. Published online October 5, 2021. doi:10.1111/bcp.15060 [PubMed 34611920]
Tonks AM. Nimodipine levels in breast milk. Aust N Z J Surg. 1995;65(9):693-694. doi:10.1111/j.1445-2197.1995.tb00684.x [PubMed 7575306]
Toossi S, Moheet AM. Intracerebral hemorrhage in women: a review with special attention to pregnancy and the post-partum period. Neurocrit Care. 2019;31(2):390-398. doi:10.1007/s12028-018-0571-3 [PubMed 29998426]
Treggiari MM, Rabinstein AA, Busl KM, et al. Guidelines for the neurocritical care management of aneurysmal subarachnoid hemorrhage. Neurocrit Care. Published online May 18, 2023. doi:10.1007/s12028-023-01713-5 [PubMed 37202712]
Weber-Schoendorfer C, Hannemann D, Meister R, et al. The safety of calcium channel blockers during pregnancy: a prospective, multicenter, observational study. Reprod Toxicol. 2008;26(1):24-30. doi:10.1016/j.reprotox.2008.05.065 [PubMed 18585452]
Wilson SR, Hirsch NP, Appleby I. Management of subarachnoid haemorrhage in a non-neurosurgical centre. Anaesthesia. 2005;60(5):470-485. doi:10.1111/j.1365-2044.2005.04152.x [PubMed 15819768]

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