Nimodipine’s primary indication is preventing cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH).
Consider nimodipine for patients meeting these criteria:
- Confirmed diagnosis of aSAH. Absence of contraindications (see below).
Careful patient selection is vital. We recommend against nimodipine for:
- Patients with significant hepatic impairment. Patients exhibiting severe hypotension requiring aggressive treatment. Patients with known hypersensitivity to dihydropyridine calcium channel blockers.
Several factors influence the decision:
Hunt and Hess grade: While nimodipine is generally used across grades, its benefit may be less pronounced in patients with very poor initial neurological status (grades IV-V). Age and comorbidities: Older age and the presence of significant comorbidities should be carefully weighed against potential risks and benefits. Patient preference and shared decision-making: Always involve the patient and family in the treatment plan, explaining both the potential benefits and risks.
Close monitoring for side effects, particularly hypotension and tachycardia, is crucial. Adjust dosage as needed based on patient response and hemodynamic stability. Regular blood pressure and heart rate monitoring are necessary throughout treatment.
Remember, this information is for guidance only; individual patient circumstances must always be considered. Consult relevant clinical guidelines and expert opinion for optimal patient care.
