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Dosage and Administration
DO NOT ADMINISTER NIMOTOP® CAPSULES INTRAVENOUSLY OR BY OTHER PARENTERAL ROUTES (see WARNINGS). If Nimotop® is inadvertently administered intravenously, clinically significant hypotension may require cardiovascular support with pressor agents. Specific treatments for calcium channel blocker overdose should also be given promptly.1
Nimotop® is given orally in the form of ivory colored, soft gelatin 30 mg capsules for subarachnoid hemorrhage.1
The oral dose is 60 mg (two 30 mg capsules) every 4 hours for 21 consecutive days, preferably not less than one hour before or two hours after meals. Oral Nimotop® therapy should commence within 96 hours of the subarachnoid hemorrhage.1
If the capsule cannot be swallowed, e.g., at the time of surgery, or if the patient is unconscious, a hole should be made in both ends of the capsule with an 18 gauge needle, and the contents of the capsule extracted into a syringe. A parenteral syringe can be used to extract the liquid inside the capsule, but the liquid should always be transferred to a syringe that cannot accept a needle and that is designed for administration orally or via a naso-gastric tube or PEG. To help minimize administration errors, it is recommended that the syringe used for administration be labeled "Not for IV Use". The contents should then be emptied into the patient's in situ naso-gastric tube and washed down the tube with 30 mL of normal saline (0.9%). The efficacy and safety of this method of administration has not been demonstrated in clinical trials.1
Patients with hepatic cirrhosis have substantially reduced clearance and approximately doubled Cmax. Dosage should be reduced to 30 mg every 4 hours, with close monitoring of blood pressure and heart rate.1
Sources:
- Nimotop® (nimodipine) Capsules Prescribing Information
December 2005
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DO NOT ADMINISTER NIMOTOP INTRAVENOUSLY OR BY OTHER PARENTERAL ROUTES. DEATHS AND SERIOUS, LIFE-THREATENING ADVERSE EVENTS HAVE OCCURRED WHEN THE CONTENTS OF NIMOTOP CAPSULES HAVE BEEN INJECTED PARENTERALLY
(See
WARNINGS and DOSAGE AND ADMINISTRATION.) |
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- In patients with SAH, Nimotop® controls damage with a low side effect profile.
- Decreased blood pressure is the most common side effect, occurring in 4.4% of patients. Blood pressure should be monitored during therapy.1
- Other side effects occurring at a low frequency of ≥1.0% include headache, nausea, and bradycardia.1
- No clinically significant effects on hematologic factors, renal or hepatic function, or carbohydrate metabolism have been causally associated with oral nimodipine.1
- Nimotop® does not appear to affect anesthetic management.2
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Sources:
- Nimotop® (nimodipine) Capsules Prescribing
Information December 2005
- Stullken EH, Johnston WE, Prough DS. Implications of nimodipine prophylaxis of cerebral vasospasm on anesthetic management during intracranial aneurysm clipping. J. Neurosurg. 1985; 62:200-205.
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© Bayer HealthCare Pharmaceuticals.
Bayer HealthCare Pharmaceuticals
6 West Belt
Wayne, NJ 07470
The information provided on Bayer products is only intended for the United States audience. Regulatory requirements, regulations, laws, and distribution of information about drug products may vary from country to country. Product names and indications (product uses) also may be different in different countries. The prescribing information provided here is based on United States labeling and may not be appropriate outside of the US.
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