Nimodipine: what it is and why it matters
Nimodipine is a calcium channel blocker doctors most commonly use after a subarachnoid hemorrhage (bleeding around the brain). Its main goal is to lower the risk of delayed brain injury from blood-vessel spasms. If you or someone you care for has had a brain bleed, nimodipine is often part of the treatment plan — but it needs to be handled carefully.
How nimodipine is used
The usual adult dose for subarachnoid hemorrhage is 60 mg by mouth every four hours for 21 days. That’s the regimen hospitals and neurologists typically follow. There’s a critical safety rule: nimodipine intended for oral use must not be given intravenously. Accidental IV administration has caused severe low blood pressure and fatal outcomes. If swallowing capsules is a problem, some formulations can be given as an oral solution — always follow hospital instructions or pharmacist guidance.
Expect the drug to be started in hospital and continued after discharge if your doctor recommends it. Nimodipine won’t reverse the bleed, but it reduces the chance of secondary brain damage from vessel spasm, which can improve recovery.
Side effects, monitoring, and interactions
The most common side effect is low blood pressure. You may notice dizziness, lightheadedness, or a fast heartbeat. Headache, nausea, and flushing are also possible. That’s why blood pressure and heart rate are checked regularly while you’re on it.
Watch drug interactions closely. Nimodipine is processed by the liver enzyme CYP3A. Strong CYP3A inhibitors — for example, some antifungals (like ketoconazole), certain antibiotics (like clarithromycin), and some heart medicines — can raise nimodipine levels and increase the risk of low blood pressure. Grapefruit and grapefruit juice can do the same. Strong CYP3A inducers (like rifampin) may lower nimodipine levels and reduce effectiveness. If you take other blood-pressure medicines, your doctor may adjust doses to avoid excessive drops.
Tell your medical team about all medicines, supplements, and herbal products you use. If you’re pregnant, breastfeeding, or have severe liver problems, talk with your doctor about risks and alternatives.
Quick practical tips: take nimodipine exactly as prescribed, don’t skip doses, and avoid driving if you feel dizzy. If you faint or have signs of very low blood pressure (extreme lightheadedness, rapid breathing, confusion), get medical help right away.
Buying and handling nimodipine safely
If you need to fill a prescription online, use a licensed pharmacy with verifiable contact details and a prescription requirement. Avoid sites that sell prescription drugs without asking for a prescription. Check reviews, look for clear return/shipping policies, and confirm the medicine matches the label and packaging you expect. If anything looks off — unusual pills, missing safety seals, or unresponsive customer service — don’t use the product and consult your pharmacist or doctor.
Have questions about a dose change, missed dose, or side effect? Call your prescribing clinician or pharmacist. Nimodipine can make a big difference after a brain bleed, but safe use and good monitoring matter more than ever.
