Nimocal
Generic Name
nimocal-30-mg-tablet
Manufacturer
MediCorp Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nimocal 30 mg tablet | ৳ 5.00 | ৳ 50.00 |
Description
Overview of the medicine
Nimocal is a selective cerebral vasodilator used to prevent and treat neurological deficits resulting from cerebral vasospasm after subarachnoid hemorrhage (SAH). It works by inhibiting calcium influx into smooth muscle cells of the cerebral arteries.
Uses & Indications
Dosage
Adults
30 mg every 4 hours for 21 consecutive days, starting within 96 hours of subarachnoid hemorrhage.
Elderly
No specific dose adjustment required unless hepatic impairment is present. Monitor blood pressure closely.
Renal_impairment
Use with caution. Consider dose reduction in severe renal impairment (creatinine clearance <20 mL/min).
How to Take
Administer orally, preferably on an empty stomach (at least one hour before or two hours after meals). Swallow the tablet whole with water; do not crush or chew.
Mechanism of Action
Nimocal selectively inhibits the influx of calcium ions into vascular smooth muscle cells, particularly in the cerebral arteries. This leads to relaxation of vascular smooth muscle, resulting in cerebral vasodilation and increased cerebral blood flow, which helps to mitigate the effects of vasospasm.
Pharmacokinetics
Onset
Within 30 minutes, full effect within hours.
Excretion
Primarily excreted in the urine (approx. 50%) and feces (approx. 30%) as metabolites.
Half life
Approximately 1-2 hours (initial phase); 5-10 hours (terminal phase).
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations occurring within 1-2 hours.
Metabolism
Extensively metabolized in the liver via cytochrome P450 3A4 (CYP3A4) pathway.
Side Effects
Contraindications
- Known hypersensitivity to nimocal or any component of the formulation
- Severe hepatic impairment
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
Drug Interactions
Cimetidine
May significantly increase nimocal plasma concentrations, requiring dose adjustment.
Antihypertensives
May potentiate the hypotensive effect of nimocal.
Phenobarbital, Phenytoin, Carbamazepine
May decrease nimocal plasma concentrations due to enzyme induction.
Strong CYP3A4 inducers (e.g., Rifampicin, St. John's Wort)
Should be avoided as they can substantially reduce nimocal efficacy.
Strong CYP3A4 inhibitors (e.g., Ketoconazole, Ritonavir, Erythromycin)
Contraindicated due to significant increase in nimocal levels.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children. Do not freeze.
Overdose
Symptoms of overdose may include marked hypotension, bradycardia, flush, and gastrointestinal distress. Management involves symptomatic and supportive measures, including gastric lavage or administration of activated charcoal. Close monitoring of vital signs is essential.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Nimocal is excreted in breast milk; avoid use during lactation due to potential adverse effects on the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture.
Availability
Pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated that Nimocal significantly reduces the incidence and severity of ischemic neurological deficits associated with cerebral vasospasm following SAH, improving patient outcomes.
Lab Monitoring
- Blood pressure monitoring (especially during initial treatment)
- Liver function tests (periodically during prolonged use)
- Renal function tests
Doctor Notes
- Emphasize strict adherence to the 4-hourly dosing schedule for optimal efficacy in SAH patients.
- Closely monitor blood pressure, especially during the initial phase of treatment, and manage hypotension appropriately.
- Counsel patients regarding potential drug-food interactions, particularly grapefruit avoidance, to prevent increased plasma levels and adverse effects.
Patient Guidelines
- Take medicine exactly as prescribed by your doctor, even if you feel better.
- Do not stop taking Nimocal without consulting your doctor.
- Report any unusual symptoms, especially severe dizziness, fainting, or persistent nausea, to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Nimocal may cause dizziness, lightheadedness, or drowsiness, especially at the beginning of treatment. Avoid driving or operating heavy machinery until you know how this medication affects you.
Lifestyle Advice
- Avoid consuming grapefruit or grapefruit juice while on this medication.
- Limit or avoid alcohol consumption as it may increase the risk of side effects.
- Maintain a balanced diet and regular exercise as advised by your healthcare provider.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.