Nimodipine — clear, practical advice for patients and caregivers
Nimodipine is a calcium channel blocker most often used after a subarachnoid hemorrhage (bleeding around the brain) to help prevent blood vessel spasms. It’s not a general blood-pressure drug for everyday use — it’s prescribed in a specific context because it helps keep brain blood flow steadier after bleeding.
How to take nimodipine
Follow your doctor’s instructions exactly. Typical adult dosing after a subarachnoid bleed is 60 mg every four hours by mouth for 21 days, but your clinician may change that based on your condition. Take nimodipine on an empty stomach — about one hour before or two hours after a meal — to improve absorption. If you’re using a liquid form, measure carefully. Don’t crush or chew extended‑release capsules unless your prescriber tells you otherwise.
If you miss a dose, take it as soon as you remember unless the next dose is close. Do not double up to make up for a missed dose. If you vomit after taking a dose, call your healthcare team — they may want to re-dose or monitor you.
Common side effects and what to watch for
Many people tolerate nimodipine well. The most common side effects are low blood pressure (feeling lightheaded or faint), headache, flushing, nausea, and swelling in the legs. Because nimodipine can lower blood pressure, sit or lie down if you feel dizzy when getting up.
Seek immediate medical help if you have very low blood pressure, fainting, a fast or irregular heartbeat, severe allergic reaction (rash, swelling, trouble breathing), or any sudden worsening of neurological signs like increased confusion or weakness.
Keep routine checks of blood pressure and follow any instructions about monitoring in the hospital or at home. After brain bleeding, teams often watch patients closely while on nimodipine.
Drug interactions: nimodipine is processed by the liver enzyme CYP3A4. Strong CYP3A4 inhibitors — for example, some antifungal drugs, certain antibiotics, and grapefruit juice — can raise nimodipine levels and increase side effects. Strong CYP3A4 inducers can lower levels and reduce effectiveness. Always tell your doctor about prescription meds, over‑the‑counter drugs, and supplements.
Special notes: nimodipine is not given by IV injection — that has caused serious harm in the past. Only use the oral forms your provider prescribes. Pregnant or breastfeeding people should discuss risks and benefits with their clinician.
Practical tips: store nimodipine at room temperature away from heat and moisture. Use a pillbox or alarm to track frequent dosing. If you’re caring for someone on nimodipine after a brain bleed, ask the medical team for clear written instructions about timing, monitoring blood pressure, and signs that need urgent attention.
If you have questions about interactions, dosing changes, or side effects, call your prescriber or pharmacist — don’t rely only on internet searches. Nimodipine can be very helpful in the right situation, but it needs careful use and monitoring.