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Nimotop S 30 mg film-coated tablets – nimodipine to prevent consequences of vasospasm after subarachnoid haemorrhage
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- Stock: Zabrana online prodaje
- Brand: BAYER products
- Model: BR-6057626
Nimotop S contains nimodipine, a medicine from the group of calcium channel blockers (dihydropyridine derivatives, ATC C08CA06). It is used to prevent changes in brain function after bleeding into the space around the brain (subarachnoid haemorrhage) caused by a ruptured aneurysm.
Two forms are authorised in Serbia: Nimotop S 30 mg film-coated tablets and Nimotop S solution for infusion 10 mg/50 mL. Treatment starts in hospital, and the tablets are usually prescribed to continue treatment after the infusion has been stopped. This page focuses mainly on the tablets; the solution for infusion is given only by healthcare professionals.
Important warning
- Nimotop S tablets are used in hospital and exceptionally dispensed on prescription to continue treatment at home (SZR status); the solution for infusion is for hospital use only (SZ status).
- The tablets must not be taken at the same time as Nimotop S solution for infusion.
- They must not be taken with rifampicin, phenobarbitone, phenytoin or carbamazepine, nor within one month of a heart attack.
- The medicine can lower blood pressure; do not drink grapefruit juice or eat grapefruit (the effect lasts at least 4 days).
- Do not take more than prescribed; treatment lasts up to 21 days.
- Read the package leaflet before use. This page is for information only and is not an offer to buy the medicine online.
What is Nimotop S used for and how should it be taken?
Key facts about the medicine
| Medicine name | Nimotop® S, 30 mg, film-coated tablets (and Nimotop® S, 10 mg/50 mL, solution for infusion) |
|---|---|
| Active substance | nimodipine |
| Strength | 30 mg nimodipine per film-coated tablet; 10 mg nimodipine in 50 mL solution for infusion |
| Pharmaceutical form | film-coated tablet; solution for infusion |
| Therapeutic group | calcium channel blockers – dihydropyridine derivatives (ATC C08CA06) |
| Pack | tablets: 10 blisters of 10 film-coated tablets (100 tablets); infusion: glass vial with 50 mL |
| Marketing authorisation holder / manufacturer | Medis Pharma d.o.o. Beograd (since 23.05.2025) / Bayer AG, Leverkusen, Germany; for the tablets also Bayer, farmacevtska družba d.o.o., Ljubljana, Slovenia |
| Dispensing status | tablets: SZR; solution for infusion: SZ |
What is Nimotop S used for?
According to the summary of product characteristics, Nimotop S is used for the prevention of ischaemic neurological deficit caused by cerebral vasospasm (spasm of the brain blood vessels) following subarachnoid haemorrhage resulting from a ruptured aneurysm.
Use is not recommended in subarachnoid haemorrhage caused by a head injury (traumatic subarachnoid haemorrhage), because a positive benefit-risk ratio has not been established.
| Form | Dispensing status | Use (according to the leaflet) |
|---|---|---|
| 30 mg film-coated tablets (100 tablets) | SZR – hospital use; exceptionally on prescription to continue treatment at home | 2 tablets every 4 hours (360 mg per day), up to 21 days in total |
| Solution for infusion 10 mg/50 mL (vial) | SZ – hospital use only | continuous IV infusion given by a doctor or nurse; at least 5, at most 14 days |
How is Nimotop S taken and dosed?
Film-coated tablets (adults):
- Recommended dose: 2 tablets every 4 hours, which is the maximum daily dose of 12 tablets (360 mg).
- Start: prophylactic use starts within 4 days of the onset of subarachnoid bleeding.
- Duration: treatment lasts up to 21 days; in case of surgery it is continued so that the total duration of nimodipine treatment is 21 days.
- Method of administration: swallow the tablets with a little water, with or without food.
- Side effects: the doctor reduces the dose or stops treatment if necessary.
Solution for infusion: given by a doctor or nurse as a slow infusion into a vein – 5 mL/hour for the first 2 hours, then 10 mL/hour if blood pressure does not fall; for body weight below 70 kg or unstable blood pressure the doctor calculates the dose. The infusion lasts at least 5 and at most 14 days; the total duration of infusion and tablet treatment should not exceed 21 days. Infusion and tablets are not given at the same time.
Special patient groups
- Children and adolescents under 18 years: safety and efficacy have not been established – the medicine is not used.
- Older people: no special dose adjustment requirements.
- Liver impairment: in severe impairment, especially cirrhosis, the effects and side effects (e.g. fall in blood pressure) may be more pronounced – the doctor reduces the dose according to blood pressure or considers stopping; constant supervision and blood pressure monitoring are needed.
- Kidney impairment (infusion): the doctor monitors kidney function during treatment.
Contraindications – when the medicine must not be used
- concomitant use of Nimotop S tablets and solution for infusion;
- a heart attack within the last month;
- angina pectoris with attacks that have recently become more frequent and severe;
- allergy to nimodipine or the excipients;
- concomitant use of rifampicin, phenobarbitone, phenytoin or carbamazepine (for the tablets).
Warnings and precautions
- Traumatic subarachnoid haemorrhage (head injury).
- Generalised brain oedema or markedly raised pressure inside the skull.
- Low blood pressure.
- Liver disease – medical supervision, laboratory tests and regular blood pressure monitoring are needed.
- The solution for infusion contains alcohol (ethanol) – important in alcohol dependence, liver disease and with medicines affected by alcohol; it also contains sodium (controlled-salt diet).
Interactions with other medicines, food and drink
Tell your doctor about all medicines you take. According to the leaflet:
- rifampicin, phenobarbitone, phenytoin and carbamazepine – must not be used with Nimotop S tablets;
- blood pressure lowering medicines (nifedipine, diltiazem, verapamil, methyldopa, alpha or beta blockers) – Nimotop S may increase their effect; injectable beta blockers must not be given with the infusion;
- cimetidine and sodium valproate – may increase the effect of nimodipine;
- fluoxetine and nefazodone; zidovudine; protease inhibitors (indinavir, ritonavir, nelfinavir, saquinavir);
- erythromycin, ketoconazole, itraconazole, fluconazole and quinupristin/dalfopristin;
- with the infusion: medicines that damage the kidneys (aminoglycosides, cephalosporins, furosemide) and medicines affected by alcohol (e.g. metronidazole, tinidazole).
Food and drink: the tablets can be taken with or without food. Do not drink grapefruit juice or eat grapefruit during treatment; treatment is not started within 4 days of last consuming grapefruit, because grapefruit increases the amount of nimodipine in the blood.
Pregnancy and breast-feeding
- Pregnancy: there are no adequate clinical studies; if use is necessary, the doctor carefully weighs the benefit for the mother against the risk to the foetus according to the severity of the condition.
- Breast-feeding: nimodipine passes into breast milk – do not breast-feed during treatment.
- Fertility: medicines such as Nimotop S may sometimes affect fertility in men; men planning to have children should talk to their doctor.
Driving and using machines
- Dizziness may occur during treatment (and with the infusion also reduced alertness). Do not drive or use machines if the medicine affects you in this way.
Possible side effects
Serious side effects – tell your doctor immediately: allergic reaction (swelling of the face, lips, tongue or throat, difficulty breathing, rash, itching, nausea or vomiting), low blood pressure (dizziness), slow heart rate, bruising or bleeding due to a low platelet count.
Uncommon (up to 1 in 100): allergic reactions, rash, low platelet count, headache, fast heartbeat, facial flushing with sweating and a feeling of warmth, nausea, low blood pressure.
Rare (up to 1 in 1,000): ileus (blockage of bowel contents), mild transient increase in liver enzymes, slow heartbeat; with the infusion also constipation and pain or swelling of the vein at the injection site. Frequency not known: hypoxia (reduced oxygen in tissues).
Overdose, missed dose and stopping treatment
- Overdose: seek medical help immediately and take the tablets with you. Low blood pressure (faintness), fast or slow heartbeat and nausea may occur.
- Missed dose: take it as soon as you remember and continue at 4-hour intervals. Do not take a double dose.
- Duration and stopping: take the tablets for as long as your doctor has prescribed (up to 21 days) and do not take more than prescribed.
When to seek medical help immediately?
- swelling of the face, lips, tongue or throat or difficulty breathing;
- severe dizziness, fainting or a very slow pulse;
- unexplained bruising or bleeding;
- severe abdominal pain, bloating and no bowel movements (possible ileus);
- difficulty breathing or a feeling of shortness of breath.
Pharmacist's advice
The schedule “2 tablets every 4 hours” means six intakes a day, including at night. Make a written plan with times (e.g. 6, 10, 14, 18, 22 and 2 o’clock) and tick off every dose taken – this makes it easier not to miss any; if you do miss one, take it as soon as you remember and continue at 4-hour intervals, without doubling.
Nimodipine can lower blood pressure – report dizziness or faintness to your doctor straight away. Remove grapefruit completely from your diet and before any new medicine – especially epilepsy medicines, antibiotics, antifungals and blood pressure medicines – check with your doctor or pharmacist whether it may be taken with Nimotop S.
Availability and price
This page is for information only. Nimotop S is used in hospital, and the tablets are exceptionally dispensed on prescription to continue treatment at home; ApotekaOnline.rs does not offer this medicine for online purchase.
Please check availability and dispensing conditions with the doctor treating you or at a pharmacy with a certified prescription.
Related information
For additional care and support with blood pressure monitoring during treatment (nimodipine can lower blood pressure), see also the category Blood pressure monitors – products in this category do not replace the medicine you have been prescribed.
Composition, pack and manufacturer
- Film-coated tablets – active substance: nimodipine 30 mg. Excipients – core: microcrystalline cellulose; maize starch; povidone; crospovidone; magnesium stearate. Coating: hypromellose (15 cP); macrogol 4000; titanium dioxide (E171); yellow iron oxide (E172).
- Appearance of tablets: round, biconvex yellowish-brown film-coated tablets marked “SK” and with the BAYER cross. Pack: 10 blisters (PP/Al or PVC/PVDC/Al) of 10 tablets (100 tablets).
- Solution for infusion – active substance: nimodipine 10 mg in 50 mL alcoholic solvent. Excipients: ethanol 96%, macrogol 400, sodium citrate, citric acid, water for injections. Clear, slightly yellowish solution in a dark glass vial containing 50 mL.
- Marketing authorisation holder: Medis Pharma d.o.o. Beograd, Milutina Milankovića 11b, Belgrade (authorisations transferred from Bayer d.o.o. Beograd on 23.05.2025). Manufacturers: Bayer AG, Leverkusen, Germany; for the tablets also Bayer, farmacevtska družba d.o.o., Ljubljana, Slovenia; for the infusion KVP Pharma + Veterinär Produkte GmbH, Kiel, Germany was added (2026).
- Marketing authorisation numbers: tablets 003196180 2025 of 10.02.2026 (renewal); solution for infusion 515-01-04532-21-001 of 04.10.2022.
Storage
- Film-coated tablets: no special storage conditions.
- Solution for infusion: store below 25 °C in the original package to protect from light; use immediately after opening.
- Keep out of the sight and reach of children; do not use after the expiry date.
Frequently asked questions
How long are Nimotop S tablets taken?
According to the leaflet, treatment lasts up to 21 days. If you previously received the infusion, the total duration of infusion and tablet treatment should not exceed 21 days. The exact duration is set by the doctor.
How do I schedule 2 tablets every 4 hours?
That is six intakes of 2 tablets a day (12 tablets, 360 mg in total). The tablets can be taken with or without food, with a little water. If you miss a dose, take it as soon as you remember and continue at 4-hour intervals – without doubling.
Why is grapefruit forbidden with Nimotop S?
Grapefruit and grapefruit juice increase the amount of nimodipine in the blood, and the effect lasts at least 4 days. They are therefore not consumed during treatment, and treatment is not started within 4 days of last consuming grapefruit.
Can I take the tablets and the infusion at the same time?
No. The tablets must not be taken at the same time as Nimotop S solution for infusion – the tablets are usually prescribed to continue treatment after the infusion has been stopped.
Sources
- ALIMS – Package leaflet for Nimotop S 30 mg film-coated tablets (PIL, Serbian)
- ALIMS – Summary of product characteristics for Nimotop S 30 mg tablets (SmPC, Serbian)
- ALIMS – Package leaflet for Nimotop S solution for infusion 10 mg/50 mL (PIL, Serbian)
- ALIMS – Summary of product characteristics for Nimotop S solution for infusion (SmPC, Serbian)
Date sources were checked: 25.10.2026.
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