Nimodipine capsules and liquid should be taken by mouth. If you are unconscious or unable to swallow, you may be given the medication through a feeding tube that is placed in your nose or directly into your stomach. Nimodipine should never be given intravenously (into a vein), because this may cause serious or life-threatening side effects or death.
Why is this medicine prescribed?
Nimodipine is used to decrease brain damage that may be caused by a subarachnoid hemorrhage (bleeding in the space surrounding the brain that occurs when a weakened blood vessel in the brain bursts). Nimodipine is in a class of medications called calcium channel blockers. It works by relaxing blood vessels in the brain to allow more blood to flow to damaged areas.
Are there other uses for this medicine?
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
How should this medicine be used?
Nimodipine comes as a capsule and an oral solution (liquid) to take by mouth or be given through a feeding tube. It is usually taken every 4 hours for 21 days in a row. Treatment with nimodipine should be started as soon as possible, no later than 96 hours after a subarachnoid hemorrhage occurs. Nimodipine should be taken on an empty stomach, at least 1 hour before a meal or 2 hours after a meal Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take nimodipine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the capsules whole with water.
It is important to finish your entire course of treatment with nimodipine. Continue to take nimodipine even if you feel well. Do not stop taking nimodipine without talking to your doctor.
What special precautions should I follow?
Before taking nimodipine,
- tell your doctor and pharmacist if you are allergic to nimodipine, any other medications, or any of the ingredients in nimodipine capsules or oral solution. Ask your doctor or pharmacist for a list of the ingredients.
- tell your doctor or pharmacist if you are taking any of the following medications: certain antifungal medications including itraconazole (Onmel, Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend); clarithromycin (Biaxin); certain medications for HIV including indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Invirase); nefazodone; and telithromycin (Ketek). Your doctor may tell you not to take nimodipine.
- tell your doctor and pharmacist what other prescription and nonprescription medications, nutritional supplements, and vitamins you are taking or plan to take. Be sure to mention any of the following: aprepitant (Emend); armodafinil (Nuvigil); alprazolam (Niravam, Xanax); amiodarone (Cordarone, Pacerone, Nexterone); atazanavir (Reyataz), bosentan (Tracleer); cimetidine (Tagamet); conivaptan (Vaprisol); cyclosporine (Gengraf, Neoral, Sandimmune); delavirdine (Rescriptor);diltiazem (Cardizem, Dilacor, Tiazac); dalfopristin/quinupristin combination (Synercid); efavirenz (Sustiva, in Atripla); erythromycin (E.E.S., E-Mycin); etravirine (Intelence); fluconazole (Diflucan); fluoxetine (Prozac, Sarafem, in Symbyax); isoniazid (in Rifater, in Rifamate); medications for high blood pressure or heart disease including diuretics ('water pills'): certain medications for hepatitis including boceprevir (Victrelis) and telaprevir (Incivek); certain medications for seizures including carbamazepine (Carbatrol, Equetro, Tegretol), phenobarbital (Luminal), and phenytoin (Dilantin); modafinil (Provigil); nafcillin (Nallpen); oral contraceptives (birth control pills); phosphodiesterase (PDE-5) inhibitors including sildenafil (Revatio, Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn); pioglitazone (Actos, in Actoplus Met, in Duetact, in Oseni); posaconazole (Noxafil);prednisone (Rayos); rifampin (Rifadin, Rifater, Rimactane, in Rifamate); rufinamide (Banzel); valproic acid (Depakene); verapamil (Calan, Covera, Tarka, Verelan); and vemurafenib (Zelburaf). Many other medications may also interact with nimodipine, so be sure to tell your doctor about all the medications that you are taking even if they do not appear on this list. Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.
- tell your doctor what herbal products you are taking, especially Echinacea and St. John's wort.
- tell your doctor if you have or have ever had liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking nimodipine, call your doctor.
What special dietary instructions should I follow?
Do not drink grapefruit juice or eat grapefruit while you are taking nimodipine.
What should I do if I forget to take a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
What side effects can this medicine cause?
Nimodipine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- muscle pain
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:
- slow or fast heartbeat
- swelling of the arms, hands, feet, or legs
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( http://www.fda.gov/Safety/MedWatch ) or by phone (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light and excess heat and moisture (not in the bathroom).
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( http://goo.gl/c4Rm4p ) for more information if you do not have access to a take-back program.
What other information should I know?
Keep all appointments with your doctor. Your doctor will monitor your blood pressure carefully during your treatment with nimodipine.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.