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Nimodipine Intravenous for Adults
Who can administer
Administration RESTRICTED - see Appendix 1
Important information
- Monitoring requirements - see under 'Monitoring'
- If changing to oral therapy, the dose is 60mg every four hours
Available preparations
Nimotop solution 10mg per 50mL vial
Reconstitution
Already in solution
Infusion fluids
- Nimodipine should not be diluted. However, a co-infusion fluid such as Sodium chloride 0.9% or Glucose 5% MUST be run alongside the nimodipine (see method below)
Methods of intravenous administration
Important: Nimodipine should be infused using a non-PVC syringe and giving set
Continuous intravenous infusion via CENTRAL line (administer using an electronically controlled infusion pump)
- Nimodipine solution must be drawn up into a 50mL syringe - use neat - do not dilute further
- Connect to a three-way stopcock using the non-PVC infusion line provided in pack
- The stopcock must allow for concomitant flow of the nimodipine solution and a co-infusion solution
- Nimodipine solution MUST be administered with a co-infusion of either of the above infusion solutions
- The co-infusion fluid should run at a rate of four times that of the nimodipine infusion (see table below)
- Connect the co-infusion to the second port of the three-way stopcock prior to its connection with the central line catheter
Rate to run co-infusion fluid at
| Nimodipine rate | Rate of administration of co-infusion fluid |
|---|---|
| 1mg per hour (5mL per hour) | 20mL per hour |
| 2mg per hour (10mL per hour) | 40mL per hour |
Dose in adults
| Prevention and treatment of aneurysmal subarachnoid haemorrhage | ||
|---|---|---|
| Patient weight | Time | Dose |
| 70kg and over | First two hours | 1mg (5mL) per hour |
| After two hours | Increase to 2mg (10mL) per hour if tolerated | |
| Less than 70kg or blood pressure unstable(BNF) | First two hours | 0.5mg (2.5mL) per hour or less |
| After 2 hours | Increased to 2mg (10mL) per hour if tolerated | |
- Use a central line
- Duration: 5 to 14 days for the parenteral product, followed up with oral nimodipine treatment, to complete a 21 day course
- The oral dose is 60mg every four hours- i.e. six doses per day
- If surgical intervention is necessary during treatment with nimodipine, continue intravenous therapy for at least 5 days post surgery
Liver disease
- Decreased drug clearance may occur in cirrhotic patients receiving intravenous nimodipine and therefore close monitoring of blood pressure is recommended in these patients
Monitoring
- Those with known renal disease and/or receiving nephrotoxic drugs should have renal function monitored closely during intravenous nimodipine treatment
- Monitor liver function
- Monitor renal function, especially if on other nephrotoxic agents, or pre-existing renal impairment
Further information
- Other compatible co-infusions include: Ringer's lactate solution, dextran 40, human albumin 5% or mannitol 10%
- Each 10mg (50mL) bottle of Nimotop solution contains approximately 10g of ethanol
Storage
- Store below 250C
- Protect from direct sunlight during administration (the infusion is stable in a syringe for 10 hours if only exposed to diffuse daylight and/or artificial light)
References
SPC January 2021
Therapeutic classification
Calcium channel blocker
IV Guide Type