Nimodipine

Nimodipine is used in the treatment of subarachnoid haemorrhage (bleeding in the space surrounding the brain). Nimodipine is also called Nimotop.

What is nimodipine?

Nimodipine is a medicine used to treat subarachnoid haemorrhage. This is a condition where there is bleeding into the space around the brain causing severe headaches and stiff neck. Nimodipine works by relaxing the muscles of the small blood vessels in the brain. This helps keep the blood vessels open and improves blood flow to the brain. Nimodipine belongs to a group of medicines called calcium channel blockers.

Dose

In Aotearoa New Zealand nimodipine is available as tablets (30 mg) and as an injection.

  • The usual adult dose is 1 or 2 tablets every 4 hours (6 times a day). You will need to wake up during the night to take some doses. For example you can take your doses at 8am, 12 noon, 4pm, 8pm, 12 midnight and 4am. 
  • A course of treatment lasts for 21 days in total. This includes the time you have been given nimodipine as an injection while in hospital.
  • Always take nimodipine exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

How to take nimodipine

  • Food and drink: Swallow the tablets whole with a full glass of water. You can take nimodipine with or without food. Avoid grapefruit and grapefruit juice while you are taking nimodipine as it can change the levels of nimodipine in your body.
  • Timing: Take your tablets at the same times each day. Keep track of the timing of your doses – there should be 4 hours between doses.
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, take the next dose at the right time. Do not take extra doses to make up for a forgotten dose. If you are not sure what to do, ask your healthcare provider.

Things to consider while you are taking nimodipine

  • Limit alcohol intake while you are taking nimodipine. Alcohol can increase your chance of side effects such as dizziness and light-headedness.
  • Tell all your health care providers that you are taking nimodipine. This includes your doctors, nurses, pharmacists and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this medicine affects you.
  • Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.

Possible side effects

Like all medicines, nimodipine can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Dizziness
  • Feeling lightheaded
  • Feeling faint when you stand up
  • This is quite common when you first start taking nimodipine
  • Be careful when getting up from either lying down or sitting to avoid falls. These effects put you at risk of falls and injuries, especially if you are an older adult.
  • Stand up slowly. If you do feel dizzy, sit or lie down for a few moments.
  • Avoid alcohol – it can make these symptoms worse.
  • Tell your doctor if this continues.
  • Headache
  • Feeling sick (nausea)
  • Runny poo (diarrhoea/hamuti)
  • This is quite common when you first start taking nimodipine.
  • Tell your doctor if these bother you.
  • Sweating flushing
  • Feeling of warmth
  • This is quite common when you first start taking nimodipine.
  • Tell your doctor if these bother you.
  • Signs of an allergic reaction such as a skin rash, itching, swelling of your lips, face or mouth, or difficulty breathing
 
  • Allergic reactions are rare but serious.
  • Tell your doctor immediately or phone Healthline free on 0800 611 116.
  • Signs of problems with your liver, such as yellowing of your skin or eyes, dark urine (pee) or pain in your abdomen (tummy/puku)
  • Liver problems are rare but serious.
  • Tell your doctor immediately or phone Healthline free on 0800 611 116. 
For more information on side effects, see the Medsafe consumer information leaflet/s below.

Did you know that you can report a medicine side effect to the Centre for Adverse Reactions Monitoring (CARM)? Report a side effect to a product.

Learn more

Nimodipine Patient Information NZ Formulary, NZ
Nimotop Medsafe Consumer Information, NZ

References

  1. Nimodipine NZ Formulary, NZ
Credits: Sandra Ponen, pharmacist. Reviewed By: Caroline Woon, Nurse Educator, Capital & Coast District Health Board; Taryn Quinn, Medication Safety Advisor, Taranaki District Health Board Last reviewed: 23 Jun 2022