Side Effects of nimodipine: A Synthesis of Findings from 29 Studies

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Original Abstract of the Article

Main Research Findings

Nimodipine is a calcium channel blocker that has been shown to be effective in treating vasospasm caused by subarachnoid hemorrhage (SAH). 16 However, its current form of application has less than optimal efficacy and causes dose-limiting hypotension in a substantial number of patients. 16 , 5

Several studies have investigated alternative delivery methods for nimodipine, such as chitosan nanoparticles, lipid nanocapsules, and slow-release microparticle systems. 13 , 9 , 22 , 12 These studies have shown that these methods can deliver nimodipine to the brain more efficiently with fewer systemic side effects, including hypotension. 9 , 12

Reasons for Side Effects

Nimodipine is a calcium channel blocker that primarily acts on blood vessels, but it can also have effects on other tissues, such as smooth muscles in the gut. 3 Its primary mechanism of action is vasodilation, which can lead to side effects like hypotension. 16 , 9 , 3 , 5

Common Side Effects

Hypotension

Nimodipine can cause hypotension due to its vasodilating effects. 16 , 9 , 3 , 5

Bradycardia

Nimodipine can cause bradycardia (slow heart rate) due to its effects on the heart's electrical conduction system. 9

Arrhythmia

Nimodipine can cause arrhythmias (irregular heart rhythm) due to its effects on the heart's electrical activity. 9

Gastrointestinal Symptoms

Nimodipine can cause gastrointestinal symptoms, such as constipation and maldigestion, due to its effects on smooth muscles in the gut. 3

Other Side Effects

Nimodipine has been linked to other side effects, including headache, dizziness, and ototoxicity. 23 , 7

Countermeasures for Side Effects

Hypotension

Monitoring blood pressure regularly and administering intravenous fluids or vasoconstrictors, if necessary, are crucial for managing hypotension. 5

Bradycardia

Bradycardia may require treatment with a pacemaker. 9

Arrhythmia

Arrhythmias might be managed with antiarrhythmic medications. 9

Gastrointestinal Symptoms

Constipation or maldigestion can be treated with laxatives or other appropriate measures. 3

Other Side Effects

Headache and dizziness might be addressed with analgesics or other suitable treatment options. 23

Comparison Between Studies

Commonalities of Studies

A common finding across various studies is that nimodipine can cause hypotension, bradycardia, and arrhythmia. 9 , 3 , 24 , 5

Differences Between Studies

Studies differ in their findings regarding the specific types and severity of side effects, which could be due to variations in administration methods, dosages, and patient populations. 9 , 3 , 24 , 5

Points to Note Regarding Application in Real Life

Nimodipine is a valuable drug for treating cerebrovascular diseases, but it is essential to be aware of its potential side effects. It is crucial to follow your doctor's instructions carefully and monitor your blood pressure regularly to manage potential risks. 9 , 3 , 24 , 5

Limitations of Current Research

While research into alternative delivery methods for nimodipine is promising, more research is necessary to fully understand the long-term effects and optimal dosages for these approaches. 9 , 12 , 13 , 22

Directions for Future Research

Future research should focus on optimizing nimodipine delivery methods to maximize efficacy while minimizing systemic side effects. Clinical trials are essential to assess the safety and effectiveness of these new delivery systems. 9 , 12 , 13 , 22

Conclusion

Nimodipine is a valuable drug for treating cerebrovascular diseases, but its side effects need careful management. By understanding these side effects and working closely with your healthcare provider, you can use nimodipine safely and effectively. 9 , 3 , 24

Keywords
Benefit Keywords
Improve neurological outcome
Reduce ischemic complications
1
Rescue therapy option
2
Neuroprotective effect
SAH treatment
4
Improves CVR
6
Cisplatin ototoxicity
7
diabetes treatment
8
Brain delivery
Reduced side effects
9
Neuroprotective properties
Reduced cell death
Sustained drug release
10
Neuroprotective effects
11
ischemic damage treatment
12
Stroke treatment
13
Cerebral vasospasm
15
aSAH treatment
16
Improved drug solubility
Neuroprotection
Selective drug targeting
17
Colorectal cancer treatment
18
Neuropathy treatment
19
Enhanced drug absorption
Improved brain delivery
Increased drug solubility
Prolonged circulation time
Reduced cardiovascular side effects
20
Improved hearing
Improved vertigo
21
DCI treatment
Neurological outcome
22
SAH management
23
Hemodynamic improvement
Mortality reduction
24
Increased recovery rate
25
Blood pressure reduction
26
Essential tremor treatment
27
Postoperative analgesic consumption
Spinal block duration
Spinal block enhancement
28
Aneurysm repair
SAH treatment
29
Risk Keywords
Cerebral side effects
Extracerebral side effects
1
Side effects
2
Ileus
3
Hemodynamic side effects
5
Nimodipine side effects
6
auditory complications
diabetes mellitus
8
Side effects
13
Decreased ECM structures
Suppressed cell proliferation
14
Side effects
15
Hypotension
16
Neurotoxicity
18
Peripheral neuropathy
19
Abdominal discomfort
21
Systemic side effects
22
Cerebral injury
23
Hypoglycemia
Hypokalemia
24
Medication side effects
27
Hypotension
Nausea
Pruritus
Respiratory depression
Sedation
Urinary retention
Vomiting
28
Cognitive deficits
Mortality
Neurologic deficits
29
Literature analysis of 29 papers
Positive Content
27
Neutral Content
0
Negative Content
2
Article Type
0
1
4
7
29
1.

Side effects of continuous intra-arterial infusion of nimodipine for management of resistant cerebral vasospasm in subarachnoid hemorrhage patients: A systematic review.

Author: VidermanD, Sarria-SantameraA, BilottaF

Improve neurological outcome
Reduce ischemic complications
Cerebral side effects
Extracerebral side effects

Nimodipine is a drug that is used to prevent cerebral vasospasm, a complication of subarachnoid hemorrhage. This review discusses the potential side effects of nimodipine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

2.

Side Effects of Long-Term Continuous Intra-arterial Nimodipine Infusion in Patients with Severe Refractory Cerebral Vasospasm after Subarachnoid Hemorrhage.

Author: KieningerMartin, FlessaJulia, LindenbergNicole, BeleSylvia, RedelAndreas, SchneikerAndré, SchuiererGerhard, WendlChristina, GrafBernhard, SilbereisenVera

Rescue therapy option
Side effects

This study aimed to generate descriptive data on the clinical course during long-term continuous intra-arterial nimodipine infusion (CIAN) therapy and expectable extracerebral side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Nimodipine: evidence for clinically significant gastrointestinal side-effects.

Author: HundE, AschoffA, TronnierV, HamplJ, KunzeS

Ileus

Nimodipine, a calcium antagonist widely used for treatment of cerebrovascular spasm, may cause life-threatening ileus.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Blood Pressure Changes in Association with Nimodipine Therapy in Patients with Spontaneous Subarachnoid Hemorrhage.

Author: RassVerena, KindlPhilipp, LindnerAnna, KoflerMario, AltmannKlaus, PutninaLauma, IanosiBogdan-Andrei, SchiefeckerAlois J, BeerRonny, PfauslerBettina, HelbokRaimund

Hemodynamic side effects

This study investigated the hemodynamic side effects of different nimodipine formulations (per os and intravenous) in patients with spontaneous subarachnoid hemorrhage (SAH) undergoing continuous blood pressure monitoring.

Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Diabetes-induced auditory complications: are they preventable? a comprehensive review of interventions.

Author: HajiabolhassanFahimeh, TavanaiElham

diabetes treatment
auditory complications
diabetes mellitus

This paper provides a comprehensive review of interventions for preventing and treating diabetes-induced auditory complications, covering various pharmacological and non-pharmacological approaches.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

A Novel Drug Delivery Carrier Comprised of Nimodipine Drug Solution and a Nanoemulsion: Preparation, Characterization, in vitro, and in vivo Studies.

Author: HuangSaixu, HuangZhiyong, FuZhiqin, ShiYamin, DaiQi, TangShuyan, GuYongwei, XuYoufa, ChenJianming, WuXin, RenFuzheng

ischemic damage treatment

A novel two-vial nanoemulsion (NIMO-TNE) was developed to improve the aqueous solubility and safety of nimodipine (NIMO), which is used to treat ischemic damage caused by subarachnoid hemorrhage.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Chitosan nanoparticles release nimodipine in response to tissue acidosis to attenuate spreading depolarization evoked during forebrain ischemia.

Author: TóthOrsolya M, MenyhártÁkos, VargaViktória Éva, HantosiDóra, Ivánkovits-KissOrsolya, VargaDániel Péter, SzabóÍrisz, JanovákLászló, DékányImre, FarkasEszter, BariFerenc

Stroke treatment
Side effects

This study evaluated the delivery of nimodipine, a calcium channel antagonist, to acidic ischemic brain tissue using chitosan nanoparticles. The nanoparticles released nimodipine in response to tissue acidosis, resulting in vasodilation and inhibition of spreading depolarizations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Does Nimodipine, a Selective Calcium Channel Blocker, Impair Chondrocyte Proliferation or Damage Extracellular Matrix Structures?

Author: KaplanNecati, YilmazIbrahim, KaraarslanNuman, KayaYasin E, SirinDuygu Y, OzbekHanefi

Decreased ECM structures
Suppressed cell proliferation

Nimodipine suppressed cellular proliferation and decreased chondroadherin (CHAD) and hypoxia-inducible factor-1 alpha (HIF-1α) expression. Type II collagen (COL2A1) expression was not detected.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Effects of Intrathecal Verapamil on Cerebral Vasospasm in Experimental Rat Study.

Author: AkkayaEnes, EvranŞevket, ÇalışFatih, ÇevikSerdar, HanımoğluHakan, SeyithanoğluMehmet Hakan, KatarSalim, KarataşErsin, KoçyiğitAbdurrahim, SağlamMustafa Yasin, HatiboğluMustafa Aziz, KaynarMehmet Yaşar

Cerebral vasospasm
Side effects

This study evaluated the vasodilator and neuroprotective effects of intrathecal verapamil, a calcium-channel blocker, in an experimental subarachnoid hemorrhage-induced vasospasm model. While verapamil has shown promise for cerebral vasospasm, it has not been widely accepted due to side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

In vitro and in vivo testing of a novel local nicardipine delivery system to the brain: a preclinical study.

Author: BayerlSimon H, GhoriAdnan, Nieminen-KelhäMelina, AdageTiziana, BreitenbachJörg, VajkoczyPeter, PrinzVincent

aSAH treatment
Hypotension

Aneurysmal subarachnoid hemorrhage (aSAH) is a critical care challenge, and nimodipine is the only FDA-approved drug for improving outcomes. However, current nimodipine formulations have limited efficacy and can cause hypotension. This study investigates a novel formulation of the calcium channel blocker nicardipine, evaluating its release dynamics in vitro and local tolerance in vivo using a chronic cranial window model in mice.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

A Systematic Review of Diuretics in the Medical Management of Ménière's Disease.

Author: CrowsonMatthew G, PatkiAniruddha, TucciDebara L

Improved hearing
Improved vertigo
Abdominal discomfort

Oral diuretic therapy may be beneficial in the medical management of Ménière's disease. Improvement in vertigo episode frequency was consistently reported, with less convincing evidence for improvement in hearing outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

23.

Perioperative measures to improve outcome after subarachnoid hemorrhage-revisiting the concept of secondary brain injury.

Author: SteigerHans-Jakob, BeezThomas, BeseogluKerim, HänggiDaniel, KampMarcel A

SAH management
Cerebral injury

This review examined the progress in managing aneurysmal subarachnoid hemorrhage (SAH) and identified factors responsible for the decreasing case fatality rate over the past decades. Advances in general neurocritical care and more active treatment of elderly patients are likely contributing factors. The review also discussed the limitations of pharmacological strategies to prevent secondary neuronal damage after SAH.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Treatment for calcium channel blocker poisoning: a systematic review.

Author: St-OngeM, DubéP-A, GosselinS, GuimontC, GodwinJ, ArchambaultP M, ChaunyJ-M, FrenetteA J, DarveauM, Le SageN, PoitrasJ, ProvencherJ, JuurlinkD N, BlaisR

Hemodynamic improvement
Mortality reduction
Hypoglycemia
Hypokalemia

High-dose insulin and extracorporeal life support were the interventions supported by the strongest evidence for calcium channel blocker poisoning, although the evidence is of low quality.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

25.

Prospective investigation of nimodipine for acute vocal fold paralysis.

Author: RosenClark A, SmithLibby, YoungVyvy, KrishnaPriya, MuldoonMatthew F, MuninMichael C

Increased recovery rate

Nimodipine is an effective treatment for acute vocal fold paralysis (AVFP) in an animal model. A prospective, open-label trial of 28 patients with AVFP showed that 60% of paralyzed vocal folds experienced recovery of purposeful motion after treatment with nimodipine, which is significantly higher than the 20% recovery rate reported in historical controls.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

26.

Drugs for treatment of very high blood pressure during pregnancy.

Author: DuleyLelia, MeherShireen, JonesLeanne

Blood pressure reduction

Very high blood pressure during pregnancy can be dangerous for both mother and baby. While medications are used to lower blood pressure quickly and safely, there's uncertainty about which medications work best, their safety, and how they affect other pregnancy outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

27.

Update on treatment of essential tremor.

Author: ZesiewiczTheresa A, ShawJessica D, AllisonKevin G, StaffettiJoseph S, OkunMichael S, SullivanKelly L

Essential tremor treatment
Medication side effects

Propranolol is the only FDA-approved medication for essential tremor (ET), but other medications, such as primidone, topiramate, and atenolol, may also be effective. Deep brain stimulation (DBS) is an alternative treatment for patients who don't respond well to medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

29.

Subarachnoid Hemorrhage International Trialists data repository (SAHIT).

Author: MacdonaldR Loch, CusimanoMichael D, EtminanNima, HanggiDaniel, HasanDavid, IlodigweDon, JajaBlessing, LantiguaHector, Le RouxPeter, LoBenjamin, Louffat-OlivaresAda, MayerStephan, MolyneuxAndrew, QuinnAudrey, SchweizerTom A, SchenkThomas, SpearsJulian, ToddMichael, TornerJames, VergouwenMervyn D I, WongGeorge K C,

Aneurysm repair
SAH treatment
Cognitive deficits
Mortality
Neurologic deficits

The Subarachnoid Hemorrhage International Trialists (SAHIT) data repository was established to facilitate prognostic analysis and optimize the design and analysis of phase III trials in aneurysmal subarachnoid hemorrhage (SAH).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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