Nymalize 60 mg/20 mL oral solution

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Medication name

Generic name:
Nimodipine - oral

Pronunciation
(nye-MOE-di-peen)

Brand name(s)
Nymalize

Warning

This medication should not be given by injection. Accidental injection of nimodipine can cause serious (rarely fatal) side effects (such as low blood pressure, slow heartbeat). Consult your doctor or pharmacist for details.

Uses

Nimodipine is used to decrease problems due to a certain type of bleeding in the brain (subarachnoid hemorrhage-SAH).

Nimodipine is called a calcium channel blocker. The body naturally responds to bleeding by narrowing the blood vessel to slow blood flow. However, when the bleeding is in the brain, stopping blood flow causes more brain damage. Nimodipine is thought to work by relaxing narrowed blood vessels in the brain near the area of bleeding so blood can flow more easily. This effect reduces brain damage.

Other uses

This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This drug may also be used to decrease problems due to stroke.

How to use

See also Warning section.

Read the Patient Information Leaflet if available from your pharmacist before you start taking nimodipine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Nimodipine is usually started as soon as possible after the start of bleeding in the brain, usually within 4 days. Nimodipine is usually taken every 4 hours or as directed by your doctor.

If you are taking the tablet form of this medication, take it by mouth with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise. Do not lie down for at least 10 minutes after taking this medication. Swallow the tablet whole. Do not crush.

If you are taking the capsule form of this medication, take it by mouth at least 1 hour before and 2 hours after meals, or as directed by your doctor. Swallow the capsule whole. If you cannot swallow a whole capsule, you may poke a hole in the capsule, draw the liquid out with a syringe, and give it by mouth or through a nasogastric tube with an oral syringe. Do not mix the contents of the capsule with other liquids. Doing so may prevent the medication from working. Do not inject this medication.

If you are using the liquid form (oral solution) of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Use the liquid form at least 1 hour before and 2 hours after meals. The liquid form may also be given through a tube into the stomach (nasogastric or gastric tube). If you are giving this medication through a nasogastric or gastric tube, ask your health care professional for detailed instructions on how to give it.

Do not take antacids for 2 hours before or after taking nimodipine tablets. Doing so may prevent the medication from working.

Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.

The dosage is based on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. It is important to continue taking this medication even if you feel well, and even if you do not see any improvement in your symptoms. Consult your doctor or pharmacist for details.

Do not suddenly stop taking this medication without consulting your doctor. This medication is usually taken for 2 to 4 weeks. Follow your doctor's directions carefully. Your condition may become worse if the drug is stopped too soon.

Tell your doctor if your condition worsens.

Side effects

Dizziness, lightheadedness, flushing, or swelling ankles/feet may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

  • fainting
  • slow/fast heartbeat
  • severe abdominal pain
  • stomach bloating
  • inability to have a bowel movement for more than 3 days
  • severe nausea/vomiting
  • vision changes

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking nimodipine, tell your doctor or pharmacist if you are allergic to it; or to other dihydropyridine calcium channel blockers (such as amlodipine, nifedipine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • chest pain/recent heart attack
  • low blood pressure
  • recent head injury
  • liver disease

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially dizziness, or swelling of ankles/feet. Dizziness can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Drug interactions

See also How To Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug are:

  • drugs for high blood pressure (such as beta blockers including propranolol and metoprolol, ACE inhibitors such as benazepril and enalapril)
  • other calcium channel blockers (such as diltiazem, verapamil)

Other medications can affect the removal of nimodipine from your body, which may affect how nimodipine works. Examples include cimetidine, azole antifungals (such as itraconazole), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), St. John's wort, drugs used to treat seizures (such as carbamazepine, phenytoin), among others.

Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Notes

Laboratory and/or medical tests (such as liver function tests, blood pressure, heart rate) may be performed from time to time to monitor your progress or check for side effects. Consult your doctor for more details.

Missed dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not freeze. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Important note

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised October 2018.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.