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Nymalize
Nymalize (generic name: nimodipine) is an oral solution used to improve outcomes in patients who have experienced a subarachnoid hemorrhage (SAH), which is bleeding in the space between the brain and the tissues that cover it. This medication is specifically used to reduce the risk of vasospasm, a condition where the blood vessels in the brain constrict, reducing blood flow and increasing the risk of stroke or further brain injury. Nymalize belongs to the calcium channel blocker drug class and works by relaxing blood vessels in the brain to improve blood flow and oxygen delivery after an SAH.
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Frequently Asked Questions
How long do I need to take Nymalize?
Nymalize is typically taken for 21 days following a subarachnoid hemorrhage to reduce the risk of vasospasm and improve neurological outcomes.
Can Nymalize be given as an injection?
No, Nymalize is for oral administration only. It should never be injected or given intravenously, as this can cause serious cardiovascular complications.
Can I take Nymalize with food?
It is recommended to take Nymalize on an empty stomach, either 1 hour before or 2 hours after a meal, to ensure proper absorption.
Can Nymalize cause low blood pressure?
Yes, one of the common side effects of Nymalize is hypotension (low blood pressure). Patients with pre-existing low blood pressure should be monitored closely.
What should I do if I miss a dose of Nymalize?
If you miss a dose, take it as soon as you remember. If it is close to your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not double up doses.
Comprehensive Drug Guide
How Does Nymalize Work?
Nymalize works by inhibiting the flow of calcium ions into the smooth muscle cells of the blood vessels in the brain, which helps to relax and dilate these blood vessels. By relaxing the blood vessels, Nymalize helps prevent cerebral vasospasm (narrowing of the blood vessels) that often occurs after a subarachnoid hemorrhage. This improved blood flow reduces the risk of further brain injury and stroke.
Common Dosages
- 60 mg (20 mL) every 4 hours for 21 days.
Typical Dosing
- The typical dose of Nymalize for adults after a subarachnoid hemorrhage is 60 mg (20 mL) administered orally every 4 hours for 21 consecutive days.
- Nymalize should be taken on an empty stomach, at least 1 hour before or 2 hours after meals.
Typical Dosing
FDA Approved Indications
- Improving neurological outcomes in adults who have experienced a subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms.
Who Shouldn't Take Nymalize?
- Known hypersensitivity to nimodipine or any other ingredients in the formulation.
- Severe hypotension (low blood pressure), as nimodipine can further lower blood pressure.
Advice From The Pharmacist
- Take Nymalize exactly as prescribed by your doctor. Ensure it is taken orally and not administered intravenously, as this could lead to serious cardiovascular complications.
- Nymalize should be taken on an empty stomach to ensure optimal absorption. Take it 1 hour before or 2 hours after meals.
- If you miss a dose, take it as soon as possible, but do not double up on doses if it is close to the next scheduled dose.
- Store Nymalize at room temperature, away from moisture and direct sunlight.
- Avoid drinking grapefruit juice while taking Nymalize, as it may increase the concentration of the drug in the blood and raise the risk of side effects.
Side Effects of Nymalize
Common Side Effects
- Low blood pressure (hypotension)
- Nausea
- Headache
- Diarrhea
- Dizziness
Uncommon/Severe Side Effects
- Severe hypotension or fainting
- Bradycardia (slow heart rate)
- Chest pain
- Allergic reactions (rash, itching, swelling, or difficulty breathing)
Risks and Warnings of Nymalize
- Hypotension: Nymalize can lower blood pressure, so patients with a history of low blood pressure or cardiovascular issues should be monitored closely during treatment.
- Drug Administration Warning: Nymalize is for oral use only and should never be injected intravenously. Intravenous administration can lead to severe cardiovascular complications such as cardiac arrest or circulatory collapse.
- Hepatic Impairment: Patients with liver disease may require dose adjustments or additional monitoring, as impaired liver function can lead to increased levels of the drug in the blood.
Interactions with Nymalize
Common Drug Interactions
- Blood pressure medications: Nymalize may interact with other antihypertensive drugs (e.g., beta-blockers, ACE inhibitors) and further lower blood pressure, requiring close monitoring.
- Grapefruit juice: Avoid grapefruit juice while taking Nymalize, as it can increase drug levels in the body and lead to enhanced side effects, including severe hypotension.
- CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): These medications may increase nimodipine levels, heightening the risk of adverse effects.
Alternatives to Nymalize
- Nimodipine capsules: Another form of nimodipine, available in oral capsule form, used for the same purpose as Nymalize to prevent cerebral vasospasm after a subarachnoid hemorrhage.
- Nicardipine: A different calcium channel blocker used to manage blood pressure, which may be considered for patients with different types of cerebral hemorrhages or stroke management.
- Verapamil: Another calcium channel blocker used in certain types of vasospasm or stroke-related treatment.
