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nimodipine (Rx)Brand and Other Names:Nimotop, Nymalize

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

gel capsule

  • 30mg

oral solution (Nymalize)

  • 60mg/20mL
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Subarachnoid Hemorrhage

Indicated for the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits with subarachnoid hemorrhage from ruptured intracranial berry aneurysms regardless of their postictus neurological condition (ie, Hunt and Hess Grades I-V)

60 mg PO q4hr for 21 days; begin therapy within 96 hours of subarachnoid hemorrhage

Dosage Modifications

Renal impairment: Supplemental dose not necessary in hemodialysis or peritoneal dialysis

Hepatic impairment: Decrease dose to 30 mg PO q4hr; closely monitor BP and HR

Subarachnoid Hemorrhage (Orphan)

New dosage form

Orphan designation for intraventricular injection for treatment of subarachnoid hemorrhage

Sponsor

  • Edge Therapeutics, Inc; 211 Warren Street, Newark, NJ 07103

Safety and efficacy not established

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Interactions

Interaction Checker

nimodipine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Reduction in systemic blood pressure (1-8%)

            Diarrhea (2-4%)

            Headache (1-4%)

            Abdominal discomfort (2%)

            Rash (1-2%)

            <1%

            Heart failure

            Arrhythmia

            Anemia

            ECG abnormalities

            GI hemorrhage

            Hepatitis

            Jaundice

            Thrombocytopenia

            Vomiting

            Thrombosis

            Rebound vasospasm

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            Warnings

            Black Box Warnings

            Do not administer contents of gel capsule or oral solution IV or by other parenteral routes

            Deaths and serious life-threatening adverse events (ie, significant hypotension requiring pressor support) have occurred when injected parenterally

            Contraindications

            Hypersensitivity

            Parenteral administration; risk of death (see Black Box Warnings)

            Cautions

            Congestive heart failure

            Reflex tachycardia resulting in angina and/or MI in patients with obstructive coronary disease reported

            Metabolism decreased in patients with hepatic impairment

            Use caution in hepatic impairment or hypertrophic subaortic stenosis

            Peripheral edema may occur within 2-3 weeks of initiating therapy

            Hypotension with or without syncope is possible (particularly with severe aortic stenosis)

            Intestinal pseudo-obstruction and ileus have been reported rarely

            A decreased dose may be required with strong CYP3A4 inhibitors

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: unknown; avoid

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Ca channel blocker with minimal effects on conduction in heart; primary effect is upon cerebral arteries to prevent vasospasm

            Highly lipophilic, allowing it to cross the blood-brain barrier

            Absorption

            Bioavailability: 13%

            Peak Plasma Time: 1 hr

            Peak Plasma Concentration: 80 ng/mL

            Distribution

            Protein Bound: 95%

            Vd: 0.43 L/kg

            Metabolism

            Hepatic P450 enzyme CYP3A4

            Elimination

            Half-Life: 1-2 hr

            Total Body Clearance: 0.84 L/kg (healthy); 1.18 L/kg (SAH)

            Excretion: Urine (50%); feces (32%)

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            Administration

            Instructions

            Gel capsule: Swallow capsule whole; if unable to swallow, may withdraw liquid content out with syringe and administer PO

            Oral solution: Administer only enterally (eg, oral, nasogastric tube, or gastric tube route); for each dose, refill the syringe with 20 mL of 0.9% NaCl and then flush any remaining contents from NG or gastric tube into the stomach

            Do not administer gel capsule contents or oral solution IV or any other parenteral route (see Black Box Warnings)

            Take at least 1 hr before or 2 hr after meals

            Avoid grapefruit juice

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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