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Nimodipine
Overview
What is Nimodipine?
Nimodipine belongs to the class of pharmacological agents known as calcium channel blockers. Nimodipine is isopropyl 2 -methoxyethyl 1,4 –dihydro -2,6 –dimethyl -4-(m-nitrophenyl) -3,5-pyridinedicarboxylate. It has a molecular weight of 418.5 and a molecular formula of CHNO. The structural formula is:
Nimodipine is a yellow crystalline substance, practically insoluble in water.
Nimodipine capsules are formulated as soft gelatin capsules for oral administration. Each liquid filled capsule contains 30 mg of nimodipine USP. Nimodipine capsules also contain the following inactive ingredients: peppermint oil, glycerin, polyethylene glycol, water, gelatin type A, titanium dioxide, light mineral oil, alcohol, shellac glaze, -butyl alcohol, propylene glycol, SDA alcohol, and FD&C red No. 40 aluminum lake.
What does Nimodipine look like?
What are the available doses of Nimodipine?
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What should I talk to my health care provider before I take Nimodipine?
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How should I use Nimodipine?
Nimodipine is indicated for the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in patients with subarachnoid hemorrhage from ruptured intracranial berry aneurysms regardless of their post-ictus neurological condition (i.e., Hunt and Hess Grades I-V).
DO NOT ADMINISTER NIMODIPINE CAPSULES INTRAVENOUSLY OR BY OTHER PARENTERAL ROUTES
Nimodipine is given orally in the form of soft gelatin 30 mg capsules for subarachnoid hemorrhage.
The recommended oral dose is 60 mg (two 30 mg capsules) every 4 hours for 21 consecutive days. In general, the capsules should be swallowed whole with a little liquid, preferably not less than one hour before or two hours after meals. Grapefruit juice is to be avoided (See ). Oral nimodipine therapy should commence as soon as possible within 96 hours of the onset of subarachnoid hemorrhage.
If the capsule cannot be swallowed, e.g., at the time of surgery, or if the patient is unconscious, a hole should be made in both ends of the capsule with an 18 gauge needle, and the contents of the capsule extracted into a syringe. A parenteral syringe can be used to extract the liquid inside the capsule, but the liquid should always be transferred to a syringe that cannot accept a needle and that is designed for administration orally or via a naso-gastric tube or PEG. To help minimize administration errors, it is recommended that the syringe used for administration be labeled “Not for IV Use”. The contents should then be emptied into the patient’s naso-gastric tube and washed down the tube with 30 mL of normal saline (0.9%).
Severely disturbed liver function, particularly liver cirrhosis, may result in an increased bioavailability of nimodipine due to a decreased first pass capacity and a reduced metabolic clearance. The reduction in blood pressure and other adverse effects may be more pronounced in these patients. Dosage should be reduced to one 30 mg capsule every 4 hours with close monitoring of blood pressure and heart rate; if necessary, discontinuation of the treatment should be considered.
Strong inhibitors of CYP3A4 should not be administered concomitantly with nimodipine (See ). Strong inducers of CYP3A4 should generally not be administered with nimodipine (See ). Patients on moderate and weak inducers of CYP3A4 should be closely monitored for lack of effectiveness, and a nimodipine dose increase may be required. Patients on moderate and weak CYP3A4 inhibitors may require a nimodipine dose reduction in case of hypotension (See).
What interacts with Nimodipine?
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What are the warnings of Nimodipine?
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What are the precautions of Nimodipine?
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What are the side effects of Nimodipine?
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What should I look out for while using Nimodipine?
The concomitant use of nimodipine with strong inhibitors of CYP3A4 such as some macrolide antibiotics (e.g., clarithromycin, telithromycin), some anti-HIV protease inhibitors (e.g., delaviridine, indinavir, nelfinavir, ritonavir, saquinavir), some azole antimycotics (e.g., ketoconazole, itraconazole, voriconazole) and some antidepressants (e.g., nefazadone) is contraindicated because of a risk of significant hypotension (See ).
DEATH DUE TO INADVERTENT INTRAVENOUS ADMINISTRATION: DO NOT ADMINISTER NIMODIPINE INTRAVENOUSLY OR BY OTHER PARENTERAL ROUTES. DEATHS AND SERIOUS, LIFE THREATENING ADVERSE EVENTS, INCLUDING CARDIAC ARREST, CARDIOVASCULAR COLLAPSE, HYPOTENSION, AND BRADYCARDIA, HAVE OCCURRED WHEN THE CONTENTS OF NIMODIPINE CAPSULES HAVE BEEN INJECTED PARENTERALLY
Reduced Efficacy with CYP3A4 Inducers
Concomitant use of strong CYP3A4 inducers (e.g. rifampin, phenobarbital, phenytoin, carbamazepine, St John’s Wort) and nimodipine should generally be avoided, as nimodipine plasma concentration and efficacy may be very significantly reduced (See ).
Moderate and weak inducers of CYP3A4 may also reduce the efficacy of nimodipine to a lesser extent. Patients on these should be closely monitored for lack of effectiveness, and a nimodipine dosage increase may be required. Moderate and weak CYP3A4 inhibitors include, for example: amprenavir, aprepitant, armodafinil, bosentan, efavirenz, etravirine, echinacea, modafinil, nafcillin, pioglitazone, prednisone and rufinamide.
What might happen if I take too much Nimodipine?
There have been no reports of overdosage from the oral administration of nimodipine. Symptoms of overdosage would be expected to be related to cardiovascular effects such as excessive peripheral vasodilation with marked systemic hypotension. Clinically significant hypotension due to nimodipine overdosage may require active cardiovascular support with pressor agents. Specific treatments for calcium channel blocker overdose should also be given promptly. Since nimodipine is highly protein-bound, dialysis is not likely to be of benefit.
How should I store and handle Nimodipine?
Storage and HandlingIn the dry state store at 20° to 25°C (68° to 77°F); excursions permitted between 15° and 30°C (59° and 86°F). [See USP Controlled Room Temperature.]Protect from light.Sterile, Nonpyrogenic, Preservative-free.The container closure is not made with natural rubber latex.Storage and HandlingIn the dry state store at 20° to 25°C (68° to 77°F); excursions permitted between 15° and 30°C (59° and 86°F). [See USP Controlled Room Temperature.]Protect from light.Sterile, Nonpyrogenic, Preservative-free.The container closure is not made with natural rubber latex.Storage and HandlingIn the dry state store at 20° to 25°C (68° to 77°F); excursions permitted between 15° and 30°C (59° and 86°F). [See USP Controlled Room Temperature.]Protect from light.Sterile, Nonpyrogenic, Preservative-free.The container closure is not made with natural rubber latex.Storage and HandlingIn the dry state store at 20° to 25°C (68° to 77°F); excursions permitted between 15° and 30°C (59° and 86°F). [See USP Controlled Room Temperature.]Protect from light.Sterile, Nonpyrogenic, Preservative-free.The container closure is not made with natural rubber latex.Storage and HandlingIn the dry state store at 20° to 25°C (68° to 77°F); excursions permitted between 15° and 30°C (59° and 86°F). [See USP Controlled Room Temperature.]Protect from light.Sterile, Nonpyrogenic, Preservative-free.The container closure is not made with natural rubber latex.Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15Nimodipine Capsules are available as:30 mg: White, soft-gelatin, oblong-shape capsule. It contains a yellow solution; printed with ‘ANI 210’ in red ink.Unit Dose Package of 30 (10 x 3): NDC 62559-210-31Unit Dose Package of 100 (10 x 10): NDC 62559-210-81The capsules should be stored in the manufacturer’s original package.Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Capsules should be protected from light and freezing. Manufactured by:USGP, a division of Procaps S.A.Barranquilla, ColombiaSouth America Distributed by:ANI Pharmaceuticals, Inc.Baudette, MN 56623 9675 Rev 07/15
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
Nimodipine is a calcium channel blocker. The contractile processes of smooth muscle cells are dependent upon calcium ions, which enter these cells during depolarization as slow ionic transmembrane currents. Nimodipine inhibits calcium ion transfer into these cells and thus inhibits contractions of vascular smooth muscle. In animal experiments, nimodipine had a greater effect on cerebral arteries than on arteries elsewhere in the body perhaps because it is highly lipophilic, allowing it to cross the blood-brain barrier; concentrations of nimodipine as high as 12.5 ng/mL have been detected in the cerebrospinal fluid of nimodipine-treated subarachnoid hemorrhage (SAH) patients.
The precise mechanism of action of nimodipine in humans is unknown. Although the clinical studies described below demonstrate a favorable effect of nimodipine on the severity of neurological deficits caused by cerebral vasospasm following SAH, there is no arteriographic evidence that the drug either prevents or relieves the spasm of these arteries. However, whether or not the arteriographic methodology utilized was adequate to detect a clinically meaningful effect, if any, on vasospasm is unknown.
Non-Clinical Toxicology
The concomitant use of nimodipine with strong inhibitors of CYP3A4 such as some macrolide antibiotics (e.g., clarithromycin, telithromycin), some anti-HIV protease inhibitors (e.g., delaviridine, indinavir, nelfinavir, ritonavir, saquinavir), some azole antimycotics (e.g., ketoconazole, itraconazole, voriconazole) and some antidepressants (e.g., nefazadone) is contraindicated because of a risk of significant hypotension (See ).DEATH DUE TO INADVERTENT INTRAVENOUS ADMINISTRATION: DO NOT ADMINISTER NIMODIPINE INTRAVENOUSLY OR BY OTHER PARENTERAL ROUTES. DEATHS AND SERIOUS, LIFE THREATENING ADVERSE EVENTS, INCLUDING CARDIAC ARREST, CARDIOVASCULAR COLLAPSE, HYPOTENSION, AND BRADYCARDIA, HAVE OCCURRED WHEN THE CONTENTS OF NIMODIPINE CAPSULES HAVE BEEN INJECTED PARENTERALLY
Reduced Efficacy with CYP3A4 Inducers
Concomitant use of strong CYP3A4 inducers (e.g. rifampin, phenobarbital, phenytoin, carbamazepine, St John’s Wort) and nimodipine should generally be avoided, as nimodipine plasma concentration and efficacy may be very significantly reduced (See ).
Moderate and weak inducers of CYP3A4 may also reduce the efficacy of nimodipine to a lesser extent. Patients on these should be closely monitored for lack of effectiveness, and a nimodipine dosage increase may be required. Moderate and weak CYP3A4 inhibitors include, for example: amprenavir, aprepitant, armodafinil, bosentan, efavirenz, etravirine, echinacea, modafinil, nafcillin, pioglitazone, prednisone and rufinamide.
Nimodipine is metabolized via the cytochrome P450 3A4 system located both in the intestinal mucosa and in the liver. Drugs that are known to either inhibit or to induce this enzyme system may therefore alter the first pass or the clearance of nimodipine.
In addition, the blood pressure lowering effects of antihypertensives could be enhanced when taken concomitantly with nimodipine.
Inducers of CYP3A4
Nimodipine plasma concentration and efficacy may be significantly reduced when concomitantly administered with strong CYP3A4 inducers. Therefore strong CYP3A4 inducers (e.g. rifampin, carbamazepine, phenobarbital, phenytoin, St. John’s Wort) should generally not be administered concomitantly with nimodipine (See ).
Other moderate and weak inducers of CYP3A4 may also reduce the efficacy of nimodipine, although the magnitude of decrease in nimodipine plasma concentrations is not known. Patients on these should be closely monitored for lack of effectiveness, and a nimodipine dosage increase may be required. Moderate and weak CYP3A4 inducers include: amprenavir, aprepitant, armodafinil, bosentan, efavirenz, etravirine, Echinacea, modafinil, nafcillin, pioglitazone, prednisone and rufinamide.
Inhibitors of CYP3A4
Nimodipine plasma concentration can be significantly increased when concomitantly administered with strong inhibitors of the CYP3A4 system. As a consequence, the blood pressure lowering effect may be increased. Therefore strong CYP3A4 inhibitors should not be coadministered with nimodipine (See ). Strong CYP3A4 inhibitors include some members of the following classes:
Nimodipine plasma concentration can also be increased in the presence of moderate and weak inhibitors of CYP3A4. If nimodipine is concomitantly administered with these drugs, blood pressure should be monitored, and a reduction of the nimodipine dose may be necessary. Moderate and weak CYP3A4 inhibitors include amprenavir, aprepitant, atazanavir, amiodarone, alprozalam, cyclosporine, cimetidine, erythromycin, fluconazole, fluoxetine, isoniazid, oral contraceptives, quinuprestin/dalforpristin, and valproic acid.
Blood pressure lowering drugs
Nimodipine may increase the blood pressure lowering effect of concomitantly administered anti-hypertensives, such as:
Blood pressure should be carefully monitored, and dose adjustment of the blood pressure lowering drug(s) may be necessary.
Blood Pressure:
Hepatic Disease:
Intestinal pseudo-obstruction and ileus have been reported rarely in patients treated with nimodipine. A causal relationship has not been established. The condition has responded to conservative management.
Adverse experiences were reported by 92 of 823 patients with subarachnoid hemorrhage (11.2%) who were given nimodipine. The most frequently reported adverse experience was decreased blood pressure in 4.4% of these patients. Twenty-nine of 479 (6.1%) placebo treated patients also reported adverse experiences. The events reported with a frequency greater than 1% are displayed below by dose.
There were no other adverse experiences reported by the patients who were given 0.35 mg/kg q4h, 30 mg q4h or 120 mg q4h. Adverse experiences with an incidence rate of less than 1% in the 60 mg q4h dose group were: hepatitis; itching; gastrointestinal hemorrhage; thrombocytopenia; anemia; palpitations; vomiting; flushing; diaphoresis; wheezing; phenytoin toxicity; lightheadedness; dizziness; rebound vasospasm; jaundice; hypertension; hematoma.
Adverse experiences with an incidence rate less than 1% in the 90 mg q4h dose group were: itching, gastrointestinal hemorrhage; thrombocytopenia; neurological deterioration; vomiting; diaphoresis; congestive heart failure; hyponatremia; decreasing platelet count; disseminated intravascular coagulation; deep vein thrombosis.
As can be seen from the table, side effects that appear related to nimodipine use based on increased incidence with higher dose or a higher rate compared to placebo control, included decreased blood pressure, edema and headaches which are known pharmacologic actions of calcium channel blockers. It must be noted, however, that SAH is frequently accompanied by alterations in consciousness which lead to an under reporting of adverse experiences. Patients who received nimodipine in clinical trials for other indications reported flushing (2.1%), headache (4.1%) and fluid retention (0.3%), typical responses to calcium channel blockers. As a calcium channel blocker, nimodipine may have the potential to exacerbate heart failure in susceptible patients or to interfere with A-V conduction, but these events were not observed.
No clinically significant effects on hematologic factors, renal or hepatic function or carbohydrate metabolism have been causally associated with oral nimodipine. Isolated cases of non-fasting elevated serum glucose levels (0.8%), elevated LDH levels (0.4%), decreased platelet counts (0.3%), elevated alkaline phosphatase levels (0.2%) and elevated SGPT levels (0.2%) have been reported rarely.
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
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Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72Tips
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