Nimodipine

From Ask Dr Wiki

Contents 1 Mechanism of action 2 Therapeutic uses 3 Dose 4 Contraindications 5 Side effects 6 Drug interactions (not inclusive) 7 Comments 8 Pharmacokinetics

Mechanism of action

• While all calcium channel blockers bind to this receptor, they have different binding sites also
• Blocking the L-channels or receptors inhibits inward calcium currents into the cell -> reducing the concentration of calcium needed for muscle contraction, leading to
• Smooth muscle dilation
• Decreasing contractility of heart muscle
• Slowing of the sinoatrial node firing rate
• Increasing AV nodal conductance time

Therapeutic uses

• Sub-arachnoid hemorrhage

Dose

• Oral dose: 60 mg every 4 hours

Contraindications

Hypersensitivity to the medications Short acting agents should not be used for hypertensive urgencies Acute myocardial infarction Acute stroke

Side effects

• Headache
• Peripheral edema
• Flushing
• Reflex tachycardia (short acting agents have higher incidence)
• Rash
• Dizziness
• Hypotension

Drug interactions (not inclusive)

• Grapefruit juice with certain dihydropyridines
• All medications that can lower blood pressure
• Fentanyl has been reported to cause severe hypotension when given with certain calcium channel blockers
• This reaction may occur with all calcium channel blockers, but no data available
• H2-receptor antagonists may increase the bioavailability of many of the dihydropyridine calcium channel blockers

Comments

• Only calcium channel blocker indicated for sub-arachnoid hemorrhage

Pharmacokinetics

• Onset: not applicable
• Half-life: 1-2 hours
• Elimination: hepatic