Nimodipine is the name given to a drug. The drug belongs to the calcium channel blockers.
What is nimodipine?
Nimodipine is a calcium channel blocker; it is used primarily in the elderly to treat brain-related performance disorders such as dementia. Nimodipine is a calcium channel blocker, it is used primarily in the elderly for the treatment of brain-organic performance disorders such as dementia. Nimodipine belongs to the group of 1,4-dihydropiridines. Because the active ingredient has good cerebrospinal fluid mobility, its use is preferred in neurosurgery and neurology. The blockade of calcium channels by nimodipine provides a relaxing effect on the vascular muscles. This is particularly true for the brain.
Pharmacologic effects
The effect of nimodipine is based on the blockade of specific calcium channels within the central nervous system (CNS). In this context, the beneficial effect of the drug is primarily exerted on the blood vessels of the brain. Thus, the drug is suitable for the therapy of vasospastic circulatory disorders of the brain. The blockade occurs at the voltage-dependent calcium channels of the L-type. This results in the braking of calcium influx into smooth muscle cells. This in turn reduces muscle tone. The reduced muscle tone also provides the target effect of nimodipine, the widening of the vessel. Nimodipine exerts its effect quite quickly. Thus, the drug can easily penetrate the blood-brain barrier due to its high lipid solubility. Nimodipine is almost completely absorbed in the small intestine. Degradation of the drug is also rapid. Thus, 50 percent of the active ingredient is excreted from the body again after 60 to 120 minutes. It is therefore not uncommon for nimodipine to be used in the form of a sustained-release agent. Retardants have the property of gradually releasing the active ingredient into the body over a longer period of time. In this way, a continuous release of nimodipine can be achieved so that there is always enough of the drug in the blood.
Medical application and use
Nimodipine is administered for the treatment of dementia. In the form of an infusion, the drug can also be used to treat or prevent circulatory problems that occur following cerebral vasospasm (blood vessel spasms in the brain). This procedure can be used to ensure blood flow to the brain. Brain spasms are sometimes triggered by hemoglobin breakdown products or the neurotransmitter serotonin. In addition, nimodipine is suitable for age-related brain disorders. Nimodipine is taken orally in the form of coated tablets or infusions. The oral bioavailability is approximately 16 percent. Excretion of the drug occurs largely through the urine.
Risks and side effects
Adverse side effects are within the realm of possibility due to the administration of nimodipine. However, these do not occur in everyone, as there are major individual differences in the use of medication. In most cases, affected individuals suffer from headaches, feelings of warmth, flushing of the skin, fatigue, dizziness, palpitations, angina pectoris attacks, sensory disturbances, edema (water retention) of the legs and ankles, and swelling of the lower legs. In some cases, inflamed veins, gastrointestinal problems, nausea, lowered blood pressure, kidney function disorders, and heart attack may also occur. Immediately after nimodipine administration, liver function disorders, sweating, and interruptions of the heartbeat (extrasystoles) sometimes become apparent. Nimodipine must not be used under certain conditions. These include hypersensitivity of the patient to the drug or other calcium channel blockers related to nimodipine. It is also not advisable to use the drug in cases of increased intracranial pressure, generalized cerebral edema, and liver function limitations. The use of the calcium channel blocker is also not recommended if the patient has previously undergone prolonged treatment with antiepileptic drugs such as phenytoin, phenobarbital or carbamazepine. Nimodipine must also not be administered during pregnancy and breastfeeding. Otherwise, the active substance may pass into breast milk. The drug should also not be used in children. The reason for this is that there is insufficient research on nimodipine in children.The use of nimodipine may also cause interactions with other drugs. For example, the blood pressure-lowering effect of the calcium channel blocker is enhanced by agents that have a blood pressure-lowering effect. These include tricyclic antidepressants, vasodilators, diuretics (drainage agents) and antihypertensives. If a combination of nimodipine and diltiazem occurs, this not infrequently leads to unpleasant side effects. The use of beta-blockers such as propranolol can lead to an increased lowering of blood pressure. As a result, there is sometimes even a risk of heart failure. Nimodipine must also not be administered together with grapefruit juice. In this way, the juice impedes the breakdown of the active ingredient. It also increases the blood pressure-lowering effect of the calcium channel blocker.
