Nimotop
Nimotop
Nimotop (Nimodipine)Pharmacological action
The preparation enriching a cerebral circulation. A blocker of the calcium channels.
Mainly vasodilating an effect has on brain pots. Prevents and stops a brain vasospasm, invokes their dilating and, thereby, enriches brain blood supply.
Possesses the expressed lipophilic properties.
Indications
- Preventive maintenance and treatment of ischemic disturbances of the cerebral circulation invoked by a subarachnoidal hemorrhage;
- Acute and chronic ischemic disturbances of a cerebral circulation (for tablets);
- A dementia (for tablets);
- Preventive maintenance of attacks of a migraine (for tablets).
Dosing regimen
For preventive maintenance and treatment of ischemic disturbances of the cerebral circulation invoked by a subarachnoidal hemorrhage, infusional Nimotop solution introduce i.v. through a catheter continuously (it is desirable by means of the perfused pompe). Begin with introduction of 1 mg (5 ml)/ch during the first 2 h. At good shipping and absence of the expressed arterial hypotension through 2 h a dose enlarge to 2 mg (10 ml)/ch. Nimotop introduction do not stop at the general anaesthesia, a surgical intervention or an angiography. Introduction in an aneurysm spend during a surgical intervention in the locus of a subarachnoidal hemorrhage. Solution prepare directly ahead of introduction.
Infusional therapy should be begun not later than in 4 days after the acute season and to continue within 10-14 days after a subarachnoidal hemorrhage. After a course of infusional therapy pass to peroral Nimotop reception on 60 mg of 6 times/24h within 14-21 days, then continue treatment by a maintenance dose on 30 mg of 6 times/days
At acute ischemic disturbances of a cerebral circulation after infusional Nimotop therapy prescribe perorally in a dose on 30 mg of 6 times/24h within 7 days, then the dose is reduced to 30 mg by 3 times/days
At chronic disturbances of a cerebral circulation, a dementia and for preventive maintenance of attacks of a migraine a preparation 3 times/days If necessary prescribe perorally on 30 mg a dose it is possible to enlarge to 60 mg 3 times/days
The preparation can be accepted irrespective of food intake. Tablets should be swallowed not chewing, washing down with fluid.
Side effect
From cardiovascular system: the arterial hypotension, a tachycardia, heart rhythm disturbance, a hyperemia of the person, sense of fever are possible.
From the alimentary system: a nausea, a dyspepsia, rising of level of transaminases.
From party TSNS: giddiness, a headache, the sleep distresses, the raised psychomotor activity, aggression, hyperkinesias, depression.
From coagulating system of blood: seldom - a thrombocytopenia.
Contraindications
- A brain edema;
- Intracranial pressure substantial increase;
- The expressed disturbances of function of a liver, including a cirrhosis (for intake);
- Pregnancy;
- A lactemia (thoracal feeding);
- Hypersensitivity to preparation components.
Pregnancy and lactemia
The preparation is contraindicative to application at pregnancy and in a lactemia.
The special indicatings
It is necessary to be careful and spend correction of doses at parenteral Nimotop application at patients with the expressed disturbances of function of a liver and nephroses, at a serious pathology from cardiovascular system, at an arterial hypotension (a systolic BP less than 90 mm hg).
Infusional solution is sensitive to light influence, therefore it is necessary to avoid solution introduction at a direct sunlight.
It is necessary to consider, that Nimotop contains 200 mg of ethanol in 1 ml of solution for infusions.
Nimotop is adsorbed on polyvinylchloride (PVC), therefore it is authorised to apply perfused pompes only with polyethylene tubes and needles with polyethylene attachments (or all-metal).
Use in pediatrics
To children and teenagers about 18 years a preparation are elderly do not prescribe in view of insufficient clinical experience.
Influence on ability to driving of motor transport and to control of mechanisms
To the patients Nimotop accepting, it is necessary to abstain from employment by potentially dangerous kinds of the activity demanding special attention and speed of psychomotor reactions.
Overdosage
Symptoms: a hyperemia of the person, headaches, BP depression, heart rhythm disturbance, a dyspepsia, a nausea.
Treatment: if the specified symptoms appear after reception of tablets spend a gastric lavage with the subsequent reception of the activated coal. If necessary spend symptomatic therapy.
Medicinal interaction
At simultaneous Nimotop application with antihypertensive preparations probably intensifying of hypotensive effect.
Nimotop Application with simultaneous i.v. introduction of beta-blockers can lead to the expressed arterial hypotension and rising of risk of a decompensation of warm activity.
At simultaneous Nimotop application with aminoglycosides, cephalosporins and Furosemidum probably deterioration of function of nephroses.
Infusional solution is compatible about 5 % glucose solution, solution of a dextran of 40 and 5 % albumin solution.
Conditions and periods of storage
The preparation should be stored in the dry place protected from light at temperature from 15 to 25 C. The Period of validity of tablets - 5 years. A period of validity of solution for infusions - 2 years.
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