Active ingredient: Nimodipine - Brands, Medical Use, Clinical Data

Brands, Medical Use, Clinical Data

Drug Category

• Antihypertensive Agents
• Vasodilator Agents

Dosage Forms

• Capsules

Brands / Synonyms

Nimodipine [Usan:Ban:Inn]; Nimodipino [Inn-Spanish]; Nimodipinum [Inn-Latin]; Nimotop; Periplum

Indications

For the treatment of subarachnoid bleeding.

Pharmacology

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.

Absorption

Not Available

Toxicity

Not Available

Biotrnasformation / Drug Metabolism

Not Available

Contraindications

None known.

Drug Interactions

It is possible that the cardiovascular action of other calcium channel blockers could be enhanced by the addition of Nimotop^Ò.

In Europe, Nimotop^Ò 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.