Nimodipine
Prevention of vasospasm after aneurysmal subarachnoid hemorrhage
Indications
- Prevention of vasospasm after aneurysmal subarachnoid hemorrhage
Adult dosing
- standard: dose: 60; unit: mg; route: PO/NG q4h; interval: For 21 days from SAH onset; fixed: true
Contraindications
- Severe hypotension
Clinical pearls
- MUST be given orally or via NG tube — NEVER give IV (fatal hypotension from look-alike IV verapamil vials)
- Only medication proven to improve outcomes after SAH (not mortality, but reduces poor neurological outcomes)
- If hypotension occurs: reduce to 30mg q4h
- Start within 96 hours of SAH and continue for 21 days
Source and review
- Pickard et al., BMJ 1989; AHA/ASA SAH Guidelines 2012. Last reviewed: 2024-11-01