NIMODIPINE

Drugs in Pregnancy and Lactation.

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Name: NIMODIPINE
Class: Calcium Channel Blocker
Risk Factor:    CM

Fetal Risk Summary

Nimodipine is a calcium channel-blocking agent used to reduce the incidence and severity of ischemic deficits in patients with subarachnoid hemorrhage after rupture of congenital aneurysms. The drug produced a dose-related increase in the incidence of malformations and stunted fetuses in rabbits (1). In rats, nimodipine was embryotoxic, causing resorptions and stunted fetal growth, but except for skeletal variations, caused no malformations (1).

Two cases have been described in which the drug was used as a cerebral vasodilator for the treatment of eclampsia complicated by cerebral vasospasm and edema, but in both cases delivery of the fetus had occurred a few hours before initiation of treatment (2,3). The investigators recommended that nimodipine not be used in combination with magnesium sulfate because of the risk for maternal heart block (3).

A prospective, multicenter cohort study of 78 women (81 outcomes; 3 sets of twins) who had 1st-trimester exposure to calcium channel blockers, including 11% to nimodipine, was reported in 1996 (4). Compared with controls, no increase in the risk of major congenital malformations was found.

Breast Feeding Summary

Nimodipine and its metabolites are concentrated in the milk of lactating rats (1). No reports describing the use of the drug during human lactation have been located.

References

  1. Product information. Nimotop. Bayer, 2000.
  2. Horn EH, Filshie M, Kerslake RW, Jaspan T, Worthington BS, Rubin PC. Widespread cerebral ischaemia treated with nimodipine in a patient with eclampsia. Br Med J 1990;301:794.
  3. Belfort MA, Carpenter RJ Jr, Kirshon B, Saade GR, Moise KJ Jr. The use of nimodipine in a patient with eclampsia: color flow Doppler demonstration of retinal artery relaxation. Am J Obstet Gynecol 1993;169:204–6.
  4. Magee LA, Schick B, Donnenfeld AE, Sage SR, Conover B, Cook L, McElhatton PR, Schmidt MA, Koren G. The safety of calcium channel blockers in human pregnancy: a prospective, multicenter cohort study. Am J Obstet Gynecol 1996;174:823–8.

Index

Q&A about Nimodipine

tanu
what is the role of nimodipine in subarachnoid haemorrhage?
Nimodipine is a calcium channel blocker.
Ayesha
Subarachnoid hemorrhage is a relatively uncommon cause of headache. Most patients with headache who visit Emergency Departments (EDs) or physicians' offices have more benign tension‑type, sinus-related or migraine headaches. Among all patients with headache who presented to EDs, retrospective studies have found that approximately 1 to 4 percent had SAH. Prospective studies found that if only patients with the "worst headache" of their lives and a normal neurologic exam were considered, 12‑33% percent of such patients had SAH.(1) This proportion increased to 25% when patients whose examinations were abnormal were included. Of the 30,000 patients found to have nontraumatic SAH in the United States annually, roughly 80% have ruptured saccular aneurysms causing acute bleeding into the subarachnoid space primarily at the base of the brain. Among the remaining 20%, about half have nonaneurysmal peri-mesencephalic hemorrhages.

The rest of the info is on the website.
Uli
How do you manage a TypeII diabetic with hypertension and peripheral neuropathy, with no response2Carbamazepi?
The Patient is a 60+ years old lady who was diagnosed to be suffering from Diabetes during a routine clinical examination at a followup session to her otherwise well controlled Hypertension >30years, she had been on Atenolol and Nifedipine. Currently she is on Atenolol and Nimodipine. A trial at Physiotherapy, simple analgesics excersize has not helped much. Her major complains now burn like pain in the feet with greater concentration at the heels. She is on oral hypoglycaemics plus diet modification her blood sugar levels are good bet 4-7mMol/L
J
For diabetic neuropathy as described, there are 2 main drugs:

Neurontin and Lyrica. Lyrica is a newer drug related to neurontin, but with fewer side effects. I'm not sure how they work. Another option is Cymbalta. It is an antidepressant that also happens to help with pain, including diabetic neuropathy.
deepsadn...
Why is it that some drugs have "unknown actions" to a person's body?
The details of how drugs work in a person's body is sometimes unknown. For example, we know what nimodipine is and what its used for, but its actions are unknown. How is it safe then to actually prescribe a drug, when the course of action in one's body is unknown?
rn
every body is different and because of that, the reactions to a drug differs as well. Just like when people get an implant, their body may not accept a foreign object, but others bodys do. Some people can eat certain foods, but their bodys may react differently when they eat it. I know people who like coffee, but when they drink it, they can't stay out of the bathroom. Some people I know who drink coffee, don't get the jitters and some do. That's just the way everyone is made. You never know how a drug will react, until you take it. Thats why they have printed on the label the side effects, so you will know what to look for if your body does not react well to it.