Brands, Medical Use, Clinical Data
- Antihypertensive Agents
- Vasodilator Agents
Brands / Synonyms
Nimodipine [Usan:Ban:Inn]; Nimodipino [Inn-Spanish]; Nimodipinum [Inn-Latin]; Nimotop; Periplum
For the treatment of subarachnoid bleeding.
Nimodipine belongs to the class of pharmacological agents known as calcium channel blockers. Nimodipine is indicated for the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in patients with subarachnoid hemorrhage from ruptured congenital aneurysms who are in good neurological condition post-ictus (e.g., Hunt and Hess Grades I-III). The contractile processes of smooth muscle cells are dependent upon calcium ions, which enter these cells during depolarization as slow ionic transmembrane currents. Nimodipine inhibits calcium ion transfer into these cells and thus inhibits contractions of vascular smooth muscle. In animal experiments, nimodipine had a greater effect on cerebral arteries than on arteries elsewhere in the body perhaps because it is highly lipophilic, allowing it to cross the blood brain barrier.
Mechanism of Action
Although the precise mechanism of action is not known, nimodipine blocks intracellular influx of calcium that is thought to be a central to ischaemic neuronal damage.
Biotrnasformation / Drug Metabolism
It is possible that the cardiovascular action of other calcium channel blockers could be enhanced by the addition
In Europe, NimotopÒ was observed to occasionally intensify the effect
of antihypertensive compounds taken concomitantly by patients suffering from hypertension; this phenomenon was not
observed in North American clinical trials.
A study in eight healthy volunteers has shown a 50% increase in mean peak nimodipine plasma concentrations and a
90% increase in mean area under the curve, after a one week course of cimetidine at 1,000 mg/day and nimodipine at 90
mg/day. This effect may be mediated by the known inhibition of hepatic cytochrome P- 450 by cimetidine, which could
decrease first pass metabolism of nimodipine.