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Nimodipine: Drug information

Nimodipine: Drug information
2025© UpToDate, Inc. and its affiliates and/or licensors. All Rights Reserved.
For additional information see "Nimodipine: Patient drug information"

For abbreviations, symbols, and age group definitions 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.

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: Liver 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: Bradycardia (1%), decreased blood pressure (4%)

Gastrointestinal: Nausea (1%)

Nervous system: Headache (1%)

<1%:

Cardiovascular: Flushing, hypertension, palpitations, rebound vasospasm

Dermatologic: Diaphoresis, pruritus

Endocrine & metabolic: Increased lactate dehydrogenase, increased serum glucose

Gastrointestinal: Gastrointestinal hemorrhage, vomiting

Hematologic & oncologic: Anemia, hematoma, thrombocytopenia

Hepatic: Hepatitis, increased serum alanine aminotransferase, increased serum alkaline phosphatase, jaundice

Nervous system: Dizziness

Neuromuscular & skeletal: Muscle cramps, myalgia

Respiratory: Wheezing

Postmarketing:

Dermatologic: Psoriasis (Song 2021)

Gastrointestinal: Gastrointestinal pseudo-obstruction (including Ogilvie syndrome) (De Jesus 2022, Fahy 1996), intestinal obstruction

Respiratory: Hypoxemia (Baker 2015)

Contraindications

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

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

Tablets [Canadian product]: Hypersensitivity to nimodipine or any component of the formulation; concomitant use with phenobarbital, phenytoin, carbamazepine, or rifampin.

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

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.

Dosage Forms: US

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

Capsule, Oral:

Generic: 30 mg

Solution, Oral:

Nymalize: 6 mg/mL (5 mL, 10 mL, 237 mL) [contains alcohol, usp, methylparaben, polyethylene glycol (macrogol)]

Generic: 60 mg/20 mL (473 mL)

Generic Equivalent Available: US

Yes

Pricing: US

Capsules (niMODipine Oral)

30 mg (per each): $19.23

Solution (niMODipine Oral)

60 mg/20 mL (per mL): $5.93

Solution (Nymalize Oral)

6 mg/mL (per mL): $12.82

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:

Capsules, oral solution: Administer at least 1 hour before or 2 hours after meals.

Tablets [Canadian product]: 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: Administer at least 1 hour before or 2 hours after meals. Administer using the supplied oral syringe labeled “ORAL USE ONLY.” 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” (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." 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 with inhibitors), CYP3A4 (Minor with inducers); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential; Inhibits ENT1 and CNT3;

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 drug interactions program by clicking on the “Launch drug interactions program” link above.

Alfuzosin: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Amifostine: Blood Pressure Lowering Agents may increase hypotensive effects 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 decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may increase hypotensive effects of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor

Arginine: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

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

Barbiturates: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Benperidol: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Brigatinib: May decrease antihypertensive effects of Antihypertensive Agents. Brigatinib may increase bradycardic effects of Antihypertensive Agents. Risk C: Monitor

Brimonidine (Topical): May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Bromperidol: May decrease hypotensive effects of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may increase hypotensive effects of Bromperidol. Risk X: Avoid

Calcium Salts: May decrease therapeutic effects of Calcium Channel Blockers. Risk C: Monitor

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

Cladribine: Inhibitors of Equilibrative Nucleoside (ENT1) and Concentrative Nucleoside (CNT3) Transporters may increase 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 serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk C: Monitor

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

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

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

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

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

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

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

Dantrolene: May increase hyperkalemic effects of Calcium Channel Blockers. Dantrolene may increase negative inotropic effects of Calcium Channel Blockers. Risk X: Avoid

Dapoxetine: May increase orthostatic hypotensive effects of Calcium Channel Blockers. Risk C: Monitor

Dexmethylphenidate: May decrease therapeutic effects of Antihypertensive Agents. Risk C: Monitor

Diazoxide: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

DULoxetine: Blood Pressure Lowering Agents may increase hypotensive effects of DULoxetine. Risk C: Monitor

Flunarizine: May increase therapeutic effects of Antihypertensive Agents. Risk C: Monitor

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

Fusidic Acid (Systemic): May increase serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Management: Consider avoiding this combination if possible. If required, monitor patients closely for increased adverse effects of the CYP3A4 substrate. Risk D: Consider Therapy Modification

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

Herbal Products with Blood Pressure Increasing Effects: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Herbal Products with Blood Pressure Lowering Effects: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Hypotension-Associated Agents: Blood Pressure Lowering Agents may increase hypotensive effects of Hypotension-Associated Agents. Risk C: Monitor

Iloperidone: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Indoramin: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Inhalational Anesthetics: May increase hypotensive effects of Calcium Channel Blockers. Risk C: Monitor

Isocarboxazid: May increase antihypertensive effects of Antihypertensive Agents. Risk X: Avoid

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may increase hypotensive effects of Levodopa-Foslevodopa. Risk C: Monitor

Loop Diuretics: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Lormetazepam: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

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

Melatonin: May decrease antihypertensive effects of Calcium Channel Blockers (Dihydropyridine). Risk C: Monitor

Metergoline: May decrease antihypertensive effects of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may increase orthostatic hypotensive effects of Metergoline. Risk C: Monitor

Methylphenidate: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Molsidomine: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Naftopidil: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Neuromuscular-Blocking Agents (Nondepolarizing): Calcium Channel Blockers may increase neuromuscular-blocking effects of Neuromuscular-Blocking Agents (Nondepolarizing). Risk C: Monitor

Nicergoline: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nicorandil: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nitroprusside: Blood Pressure Lowering Agents may increase hypotensive effects of Nitroprusside. Risk C: Monitor

Obinutuzumab: May increase hypotensive effects 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 increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Perazine: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Phenobarbital-Primidone: May decrease serum concentration of NiMODipine. Risk X: Avoid

Pholcodine: Blood Pressure Lowering Agents may increase hypotensive effects of Pholcodine. Risk C: Monitor

Phosphodiesterase 5 Inhibitors: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Prazosin: Antihypertensive Agents may increase hypotensive effects of Prazosin. Risk C: Monitor

Prostacyclin Analogues: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Quinagolide: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Silodosin: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Sincalide: Drugs that Affect Gallbladder Function may decrease therapeutic effects 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 serum concentration of NiMODipine. Risk X: Avoid

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

Terazosin: Antihypertensive Agents may increase hypotensive effects of Terazosin. Risk C: Monitor

Urapidil: Antihypertensive Agents may increase hypotensive effects of Urapidil. Risk C: Monitor

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 or oral solution on an empty stomach, at least 1 hour before or 2 hours after meals. Avoid concurrent use of grapefruit juice and nimodipine capsules, oral solution, 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 arteries 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 Cmax almost doubles.

Older adult: AUC and Cmax 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: Nimotop | 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 | Nisom;
  • (CZ) Czech Republic: Dilceren | Nimotop S;
  • (DE) Germany: Nimodipin carino | Nimotop S;
  • (DO) Dominican Republic: Nimotop | Regental;
  • (EC) Ecuador: 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;
  • (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;
  • (QA) Qatar: Nimotop;
  • (RO) Romania: Dilceren;
  • (RU) Russian Federation: Dilceren | Nimodipine native | Nimopine | Nimotop | Vazonimid;
  • (SA) Saudi Arabia: Nimotop;
  • (SE) Sweden: Nimotop;
  • (SG) Singapore: Nimotop;
  • (SI) Slovenia: Nimotop S;
  • (SK) Slovakia: Dilceren | Nimotop S;
  • (SR) Suriname: Nimotop;
  • (TH) Thailand: Nimotop;
  • (TN) Tunisia: Nimotop;
  • (TR) Turkey: Nimotop;
  • (TW) Taiwan: Nimotop;
  • (UA) Ukraine: Dilceren | Nimotop;
  • (UG) Uganda: Nimotop;
  • (UY) Uruguay: Inimod | Nimoion;
  • (VE) Venezuela, Bolivarian Republic of: Nimodipina | Nimotop | Tropocer;
  • (ZA) South Africa: Nimotop;
  • (ZW) Zimbabwe: Nimotop
  1. 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]
  2. 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]
  3. 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]
  4. Baker M, Bastin MT, Cook AM, Fraser J, Hessel E 2nd. Hypoxemia associated with nimodipine in a patient with an aneurysmal subarachnoid hemorrhage. Am J Health Syst Pharm. 2015;72(1):39-43. doi:10.2146/ajhp140196 [PubMed 25511836]
  5. 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]
  6. 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]
  7. 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]
  8. 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]
  9. De Jesus O, Sánchez Jiménez J, Vicenty JC. Potential association between acute colonic pseudo-obstruction (Ogilvie syndrome) and oral nimodipine: report of two cases. Cureus. 2022;14(8):e28039. doi:10.7759/cureus.28039 [PubMed 36120238]
  10. 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]
  11. Fahy BG. Pseudoobstruction of the colon: early recognition and therapy. J Neurosurg Anesthesiol. 1996;8(2):133-136. doi:10.1097/00008506-199604000-00006 [PubMed 8829560]
  12. 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]
  13. 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]
  14. 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]
  15. 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]
  16. 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]
  17. Ito S. Drug therapy for breast-feeding women. N Engl J Med. 2000;343(2):118-126. doi:10.1056/NEJM200007133430208 [PubMed 10891521]
  18. 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]
  19. 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]
  20. Nimodipine [prescribing information]. East Brunswick, NJ: Avet Pharmaceuticals Inc; June 2020.
  21. Nimotop (nimodipine) [product monograph]. Mississauga, Ontario, Canada: Bayer Inc; September 2022.
  22. Nymalize (nimodipine) [prescribing information]. Woburn, MA: Azurity Pharmaceuticals Inc; August 2024.
  23. 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]
  24. Refer to manufacturer's labeling.
  25. 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]
  26. 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]
  27. 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]
  28. 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]
  29. 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]
  30. 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]
  31. 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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