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Nimodipine parenteral

Updated 2 Feb 2023 | Calcium channel blockers


Solution for infusion of nimodipine.

Drugs List

  • nimodipine 10mg/50ml solution for infusion
  • NIMOTOP 0.02% solution for infusion
  • Therapeutic Indications


    Treatment of neurological deficit after aneurysmal subarachnoid haemorrhage


    Nimodipine solution may be used during anaesthesia, angiography or surgical procedures.


    1 mg/hour by intravenous infusion for the first two hours (approximately 15 micrograms/kg/hour) followed by 2 mg/hour (approximately 30 micrograms/kg/hour) providing no severe decrease in blood pressure is observed.
    Patients weighing less than 70kg or with unstable blood pressure should be started on 500 micrograms/hour or less if necessary.

    Intravenous nimodipine therapy should be initiated as soon as possible after the neurological deficit occurs and should continue for at least five days (maximum of fourteen days).

    In the event of surgical intervention during treatment, administration of nimodipine should continue for at least five days, following the above dosage regime.


    Treatment of vasospasm following subarachnoid haemorrhage (unlicensed)
    Children aged 12 to 18 years
    Initially, 500 micrograms/hour (up to 1 mg/hour if bodyweight over 70kg and blood pressure stable). Increase after 2 hours to 1 to 2 mg/hour if no severe fall in blood pressure.
    Continue for at least five days (for a maximum of fourteen days).

    Children aged 1 month to 12 years
    Initially, 15 micrograms/kg/hour (up to a maximum of 500 micrograms/hour) or 7.5 micrograms/kg/hour if blood pressure unstable. Increase after 2 hours to 30 micrograms/kg/hour (up to a maximum of 2 mg/hour) if no severe decrease in blood pressure.
    Continue for at least five days (for a maximum of fourteen days).

    Additional Dosage Information

    In the event of nimodipine tablets and nimodipine solution being administered sequentially, the total duration of treatment should not exceed twenty one days.

    Nimodipine solution should not be administered for longer than fourteen days.

    Nimodipine solution and tablets should not be used concurrently.


    For intravenous administration using a central line catheter

    Nimodipine solution must be administered with a co-infusion using a three way stopcock. Co-infusion flow rate 40 ml/hour.


    Neonates under 1 month
    Acute angina
    Acute porphyria
    Myocardial infarction
    Within 1 month of a myocardial infarction
    Within 1 month of an unstable angina episode

    Precautions and Warnings

    Children 1 month to 18 years
    Systolic blood pressure below 100mmHg
    Cerebral oedema
    Epileptic disorder
    Hepatic cirrhosis
    Hepatic impairment
    Raised intracranial pressure
    Renal impairment

    Do not administer to patients with traumatic subarachnoid haemorrhage
    Sodium content of formulation may be significant
    Advise ability to drive/operate machinery may be affected by side effects
    Contains alcohol
    Do not mix with other drugs or substances
    Incompatible with PVC
    Monitor blood pressure and heart rate in patients with hepatic impairment
    Grapefruit prod increase dihydropyridine Ca channel blocker bioavailability

    Nimodipine infusion solution contains 23.7% ethanol. This may be harmful for those suffering alcoholism or impaired alcohol metabolism, and should be taken into account in high risk groups such as liver disease and epilepsy.

    Pregnancy and Lactation


    Use nimodipine with caution in pregnancy

    There is very limited information on the use of nimodipine during pregnancy.

    Schaefer (2007) suggests that calcium channel blocker exposure during the first trimester of pregnancy is an indication for a detailed ultrasound scan but, in general, calcium channel blocker exposure is not an indication for invasive diagnostic procedure or termination.

    Nimodipine is teratogenic and toxic in experimental animals.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    Use nimodipine with caution in breastfeeding.

    The manufacturer states nimodipine and its metabolites have been shown to be present in human milk at concentrations of the same order of magnitude as corresponding maternal plasma concentrations. Nursing mothers are advised not to breastfeed when taking this drug.

    Lactmed states the amount ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at

    Side Effects

    Allergic reaction
    Elevation of liver enzymes (transient)
    Gastro-intestinal symptoms
    Injection site reactions
    Phlebitis (injection site)
    Sensation of warmth
    Variation in heart rate


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: December 2013

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

    Martindale: The Complete Drug Reference, 37th edition (2011) ed. Sweetman, S. Pharmaceutical Press, London.

    Medications and Mothers' Milk, 14th Edition (2010) Hale, T. Hale Publishing, Amarillo, Texas.

    The Renal Drug Handbook. 3rd edition. (2009) ed. Ashley, C and Currie, Radcliffe Publishing Ltd, Abingdon.

    Summary of Product Characteristics: Nimotop 0.02% solution for infusion. Bayer plc. Revised October 2012.

    NICE Evidence Services Available at: Last accessed: 23 August 2017

    The Drug Database for Acute Porphyria (NAPOS)
    Available at:
    Nimodipine Last revised: October 1, 2004
    Last accessed: December 10, 2013

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Nimodipine Last revised: September 7, 2013
    Last accessed: December 10, 2013

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