Nimodipine is used to minimize ischemic neurological impairments in those who have had an aneurysmal subarachnoid haemorrhage.

Aneurysmal subarachnoid haemorrhage.

• Two tablets at 4-hourly intervals (total daily dose 360 mg) are recommended to be taken with water. Prophylactic treatment should begin four days after the commencement of subarachnoid haemorrhage and continue for 21 days.
• In the event of surgical intervention, nimodipine tablets should be taken (at the same dosage) for the remainder of the 21-day treatment term.
• If a patient has an adverse reaction, the dose should be lowered or the medication should be stopped.

Patients with hepatic impairment:

• Severely disturbed liver function, particularly liver cirrhosis, may result in an increased bioavailability of nimodipine due to a decreased first-pass capacity and a reduced metabolic clearance. The effects and side-effects, e.g. reduction in blood pressure, may be more pronounced in these patients.
• In such cases, the dose should be reduced (depending on the blood pressure) or, if necessary, discontinuation of the treatment should be considered.
• Upon co-administration with CYP 3A4 inhibitors or CYP 3A4 inducers a dose adaption may be necessary

Although uncommon, side effects associated with nimodipine are-

• headache
• dizziness
• flushing
• tachycardia/bradycardia
• diarrhea
• abdominal pain
• constipation
• depression

Headache	Dizziness	Flushing
Tachycardia	Flushing	Bradycardia

• Nimodipine should not be used in patients with traumatic subarachnoid haemorrhage since a positive benefit-to-risk ratio has yet to be established, and the specific patient groups who might benefit have yet to be identified.
• When cerebral oedema or highly elevated intracranial pressure are present, Nimodipine pills should be used with caution. Although Nimodipine medication has not been linked to an increase in intracranial pressure, close monitoring is advised in these situations or when the water content of the brain tissue is high (generalised cerebral oedema).
• Caution should be exercised in patients with hypotension.
• The cytochrome P450 3A4 system is used to break down nimodipine. Drugs that are known to inhibit or promote this enzyme system may consequently affect nimodipine's first pass or clearance.
• Before you take nimodipine, tell your doctor if you are pregnant or plan to become pregnant.