Nimocal 30 - Tablet Nimodipine - 30mg 10 Tablet(s) / Strip Square Pharmaceuticals PLC. Introduction: Nimocal 30 is a medicine used to treat and prevent further damage to the brain after bleeding around the brain (subarachnoid hemorrhage or SAH). It is known as a calcium channel blocker and helps to improve blood flow to the brain and prevent changes in brain function. Nimocal 30 is usually started as soon as possible after bleeding around the brain (or SAH) is confirmed by the doctor. The exact dose and frequency will be decided by your doctor depending on your medical condition and response to treatment. It may be taken empty stomach or with a meal, but take... Uses of Nimocal 30: Subarachnoid haemorrhage Side effects of Nimocal 30: Decreased blood pressureHeadacheIncreased heart rateNauseaRashStomach discomfortEdema (swelling)Muscle cramp How to use Nimocal 30: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Nimocal 30 may be taken with or without food, but it is better to take it at a fixed time. How Nimocal 30 works: Nimocal 30 is a calcium channel blocker. It relaxes the narrow blood vessels in the brain and makes the blood flow more easily. This prevents brain damage after bleeding around the brain. Indication: Subarachnoid haemorrhage, Stroke prevention Administration: Cap: Should be taken on an empty stomach. Take on an empty stomach 1 hr before or 2 hr after meals. Tab: May be taken with or without food. Take consistently, either always w/ or always w/o meals. Adult Dose: Oral Prophylaxis of neurological deficit following subarachnoid haemorrhage Adult: 60 mg 4 hrly beginning w/in 4 days of onset of haemorrhage and continued for 21 consecutive days. Hepatic impairment: Initially, 30 mg 4 hrly. Contraindication: Use w/in 1 mth of MI or an episode of unstable angina. Concomitant use w/ potent CYP3A4 inhibitors (e.g. clarithromycin, ritonavir, ketoconazole, nefazodone). Mode of Action: Nimodipine inhibits inflow of Ca ions into cells by blocking Ca channels or select voltage-sensitive areas resulting in relaxation of vascular smooth muscle and myocardium during depolarisation. Nimodipine has greater action on the cerebral vessels because of its high lipophilicity. Precaution: Patients w/ cerebral oedema or severely raised intracranial pressure. Contents of oral capsules should be given only by mouth or through a feeding tube. It must never be administered IV or by any other parenteral route. Hepatic and renal impairment. Pregnancy and lactation. Monitoring Parameters Careful monitoring of BP and pulse rate. Lactation: unknown; avoid Side Effect: 1-10% Reduction in systemic blood pressure (1-8%),Diarrhea (2-4%),Headache (1-4%),Abdominal discomfort (2%),Rash (1-2%) <1% Heart failure,Arrhythmia,Anemia,ECG abnormalities,GI hemorrhage,Hepatitis,Jaundice,Thrombocytopenia,Vomiting,Thrombosis,Rebound vasospasm Potentially Fatal: Angina/MI, symptomatic hypotension. Interaction: Plasma concentration and efficacy may be significantly reduced when administered w/ strong CYP3A4 inducers (e.g. rifampicin, carbamazepine, phenobarbital, phenytoin). May increase serum levels and toxicity of phenytoin. Increased plasma concentrations w/ cimetidine or sodium valproate. Potentially Fatal: Increased risk of significant hypotension w/ concomitant potent CYP3A4 inhibitors (e.g. clarithromycin, ritonavir, ketoconazole, nefazodone).