C08CA06 - Nimodipine |
Propably not porphyrinogenic |
PNP |
Rationale
Nimodipine is metabolized by CYP 3A4, but it is not observed or suspected that nimodipine has potential for induction or inhibition of any CYP-enzymes.
Chemical description
Dihydropyridine calcium antagonist.
Therapeutic characteristics
Nimodipine is indicated for the prevention of ischaemic neurological deficits following aneurysmal subarachnoid haemorrhage. It is administered orally or as an intravenous infusion.
Metabolism and pharmakokinetics
Nimodipine is metabolized by CYP 3A4.
Effects on CYP enzymes by induction or inhibition have not been extensively studied.
Formal interaction studies are also lacking but concomitant administration of oral nimodipine and diazepam, digoxin, glibenclamide, indometacin, ranitidine and warfarin did not reveal any potential for mutual interaction. (Liu 2000, SPC)
No CYP-interactions with nimodipine as perpetrator are listed in commonly used drug- interaction databases (Lexi-Interact, Norwegian medicines agency, SuperCYP, the Danish Health and medicines authority).
Nimodipine is not listed as a mechanism-based inhibitor or an inducer (Hisaka 2010, Isoherranen 2009, Pelkonen 2008).
References
- Scientific articles
- Hisaka A, Ohno Y, et al. Prediction of pharmacokinetic drug-drug interaction caused by changes in cytochrome P450 activity using in vivo information. Pharmacol Ther. 2010 Feb;125(2):230-48. #1138
- Isoherranen N, Hachad H, et al. Qualitative analysis of the role of metabolites in inhibitory drug-drug interactions: literature evaluation based on the metabolism and transport drug interaction database. Chem Res Toxicol. 2009 Feb;22(2):294-8. #1005
- Liu XQ, Ren YL, Qian ZY, Wang GJ. Enzyme kinetics and inhibition of nimodipine metabolism in human liver microsomes. Acta Pharmacol Sin. 2000;21:690–694. PMID 11501176. #4408
- Pelkonen O, Turpeinen M, et al. Inhibition and induction of human cytochrome P450 enzymes: current status. Arch Toxicol. 2008 Oct;82(10):667-715. PMID 18618097. #4347
- Preissner S, Kroll K, rt al. SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. PMID 19934256. #4409
- Government bodies
- Norwegian medicines agency. Find medicine. #1296
- Drug interaction databases
- Lexi-Interact, via UpToDate. #1152
- The Danish Health and Medicines Authority. The drug interaction database. #1298
- Summary of Product Characteristics
- The electronic Medicines Compendium (emc). Summary of Product Characteristics (SPC). Nimotop. #1294
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