Calcium-channel blocker:Prevention and treatment of ischaemic neurological deficits following subarachnoid haemorrhage
DOSE IN NORMAL RENAL FUNCTION
Prevention: 60 mg orally every 4 hours Treatment via central catheter: 1 mg/hour initially, increased after 2 hours to 2 mg/hour. If BP unstable, weight <70 kg, start with 0.5 mg/hour or less if necessary
20 to 50     : Dose as in normal renal function
10 to 20     : Dose as in normal renal function
<10           : Dose as in normal renal function
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Not dialysed. Dose as in normal renal function
HD                     :Not dialysed. Dose as in normal renal function
HDF/high flux   :Unknown dialysability. Dose as in normal renal function
CAV/VVHD      :Unknown dialysability. Dose as in normal renal function
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Anaesthetics: enhanced hypotensive effect
Antibacterials: metabolism accelerated by rifampicin
Anti-epileptics: effect reduced by carbamazepine, barbiturates, phenytoin and primidone
Antifungals: metabolism possibly inhibited by itraconazole and ketoconazoleAntihypertensives: enhanced hypotensive effect, increased risk of first dose hypotensive effect of post-synaptic alpha-blockers
Antivirals: concentration possibly increased by ritonavir
IV – First 2 hours: 1 mg (5 mL) nimodipine per hourAfter 2 hours: Infuse 2 mg (10 mL) —nimodipine per hour
Comments
Nimodipine solution must not be added to an infusion bag or bottle and must not be mixed with other drugsNimodipine solution should be administered only via a bypass into a running drip (40 mL/hour) of either sodium chloride 0.9% or glucose 5%In the event of nimodipine tablets and solution being administered sequentially, the total duration of treatment should not exceed 21 days
OTHER INFORMATION
Nimodipine solution reacts with PVC. Polyethylene tubes are suppliedPatients with known renal disease and/or receiving nephrotoxic drugs should have renal function monitored closely during IV treatment.