Nimotop® (Nimodipine) Tablets for Aneurysmal Subarachnoid Hemorrhage

What Nimotop® Is and How It Works

Nimotop® is the brand name for nimodipine, a dihydropyridine calcium channel blocker. It is used to improve neurological outcomes after aneurysmal subarachnoid hemorrhage (aSAH). The strength commonly supplied is Nimotop 30 mg tablets. Therapy is oral only and not for treating high blood pressure. CanadianInsulin is a prescription referral service. Prescriptions are verified with your clinic, and orders are filled by licensed Canadian pharmacies.

Partner pharmacies are licensed and vetted, supply authentic brand medications, offer a broad selection, and focus on value pricing. Nimodipine relaxes cerebral arteries and supports perfusion of brain tissue at risk during the vasospasm window after aSAH. This effect helps lower the incidence and severity of delayed ischemic neurological deficits. Nimotop tablets provide consistent dosing in hospital and post-ICU settings when oral administration is possible.

In clinical practice, nimodipine is started soon after aneurysm securing when feasible. It is not injected; intravenous administration of nimodipine is contraindicated. The drug’s action is selective for cerebral vessels compared with systemic vessels, but dose-related hypotension can occur, so monitoring is standard in acute care.

Dosage and Usage

• Initiation: Start as soon as possible after aneurysm rupture is secured, typically within 96 hours, per treating team protocols.
• Standard dose: 60 mg every 4 hours for 21 consecutive days (two 30 mg tablets per dose).
• Administration: Swallow tablets with water, preferably on an empty stomach (about 1 hour before or 2 hours after meals).
• Feeding tubes: Follow local protocols for oral solution or approved alternatives when swallowing is not possible.
• Adjustments: Lower starting doses (for example, 30 mg every 2–4 hours) may be used in hepatic impairment or if hypotension occurs, as directed by the care team.
• Grapefruit: Avoid grapefruit and grapefruit juice; they raise nimodipine levels.
• Drug interactions: Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, ritonavir) increase exposure. Strong inducers (e.g., rifampin, carbamazepine, phenytoin) reduce exposure.
• Missed dose: If a dose is missed, give it when remembered unless the next dose is due soon; do not double up.
• Duration: Continue through 21 days unless stopped or adjusted by the clinical team.

• Storage: Keep tablets at room temperature (15–30°C / 59–86°F) in the original packaging. Protect from light and moisture.
• Handling: Do not use if packaging is damaged or tablets are discolored.
• Travel: Carry medication in a labeled container in a carry-on bag. Avoid leaving tablets in hot cars.
• Refills: For multi-week courses, confirm supply aligns with the planned 21-day regimen before discharge or travel.

Benefits and Savings

Nimodipine reduces the incidence and severity of delayed cerebral ischemia after aSAH. The regimen is oral, standardized (60 mg every 4 hours), and well understood in neurocritical care pathways. Tablets help streamline transitions of care from ICU to step-down and rehabilitation settings.

Many customers save 60–80% vs typical U.S. prices.

Reliable access to brand and generic nimodipine supports continuity of care when patients move between inpatient and outpatient settings. Consistent supply, clear labeling, and tablet form factor also aid nursing workflows and medication reconciliation.

Side Effects and Safety

• Common effects: low blood pressure, headache, flushing, dizziness, nausea, peripheral edema, and palpitations.
• Less common: constipation, fatigue, rash, or sleep disturbances.
• Serious reactions: marked hypotension, syncope, or ischemic symptoms in susceptible patients; seek urgent assessment.
• Do not inject: Intravenous administration of nimodipine is contraindicated and has led to serious harm and death.
• Hepatic impairment: exposure may increase; lower doses and close monitoring are used.
• Drug/food interactions: avoid grapefruit; review all CYP3A4 inhibitors/inducers and antihypertensives.
• Hypoglycemia risk: nimodipine does not cause hypoglycemia, but blood pressure-lowering effects may interact with other cardiovascular agents.

Patients with unstable coronary disease or severe hypotension require careful assessment. In pregnancy and lactation, risk–benefit decisions are individualized. Some formulations may contain excipients that are not suitable for all patients; review the product label and institutional policies.

Onset Time

Nimodipine reaches steady levels over several days of regular dosing. Protective benefit is intended during the vasospasm window, typically days 3–14 after hemorrhage, and therapy continues for 21 days. Blood pressure effects can appear early in the course, especially after initial doses, and are usually monitored in controlled settings.

Symptom improvement is not immediate or directly felt in many cases. The goal is prevention of delayed ischemic deficits, reflected in neurological assessments over time rather than a rapid subjective effect.

Compare With Alternatives

Generic nimodipine tablets contain the same active ingredient and are used with the same 60 mg every 4 hours regimen. Selection between brand and generic often depends on formulary, availability, and value considerations. Both are oral and intended for use in monitored care pathways.

Nimodipine oral solution products (where available) provide an option for patients who cannot swallow tablets and have enteral access. Dosing schedules match tablet regimens, with the same interaction and blood pressure precautions. Institutions may choose the form that best supports safe administration and workflow.

Other calcium channel blockers do not replace nimodipine for this indication. Nimodipine has unique evidence for improving outcomes after aSAH and should not be substituted with agents lacking this indication.

Combination Therapy

• Commonly used alongside definitive aneurysm treatment and standard neurocritical care measures.
• May be combined with intravenous fluids and blood pressure targets individualized by the care team.
• When other antihypertensives are required, dosing adjustments and monitoring help reduce excess hypotension.
• Review interactions with strong CYP3A4 inhibitors/inducers and adjust therapy to maintain consistent nimodipine exposure.

Patient Suitability and Cost-Saving Tips

Appropriate candidates are patients treated for aneurysmal subarachnoid hemorrhage who can receive oral or enteral medication. It is not indicated for general stroke prevention, migraine, or routine hypertension management. Care teams consider blood pressure, hepatic function, drug interactions, and overall clinical stability.

Those with severe hypotension, shock, or significant hepatic impairment may require modified dosing or alternative administration plans. Institutions and caregivers should avoid grapefruit products and review interacting medications, including certain antifungals, macrolides, antivirals, and enzyme inducers.

Cost-conscious options include selecting generic nimodipine when appropriate, aligning quantity with the planned 21-day course, and coordinating one shipment for concurrent medications when possible. Placing the order ahead of discharge helps ensure continuous supply without gaps.

Authoritative Sources

Bayer Nimotop product information

Health Canada Product Monograph: NIMOTOP (nimodipine) 30 mg tablets

FDA Prescribing Information: Nimodipine

Order Nimotop® from CanadianInsulin: add to cart, upload your prescription, and we ship with prompt, express, cold-chain handling.

This page is educational and does not replace professional medical advice. Always follow the treatment plan and dosing guidance provided by the prescribing healthcare team.