{"id":55256,"date":"2024-01-14T09:11:30","date_gmt":"2024-01-14T09:11:30","guid":{"rendered":"https:\/\/medsname.com\/nimodip-nimodipine\/"},"modified":"2026-05-01T10:49:12","modified_gmt":"2026-05-01T10:49:12","slug":"nimodip-nimodipine","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/nimodip-nimodipine\/","title":{"rendered":"Nimodip (Nimodipin)"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Nimodip?<\/h3>\n<p style=\"margin:0;\"><strong>Nimodip<\/strong> je <strong>tableta obsahuj\u00edc\u00ed 30 mg nimodipinu<\/strong> od v\u00fdrobce certifikovan\u00e9ho WHO-GMP \u2014 dihydropyridinov\u00fd BKK s selektivn\u00ed cerebrovaskul\u00e1rn\u00ed aktivitou. Zaveden 1989 (Bayer jako <strong>Nimotop<\/strong>) speci\u00e1ln\u011b pro neurochirurgick\u00e9 pou\u017eit\u00ed. Na rozd\u00edl od jin\u00fdch DHP m\u00e1 nimodipin vysokou lipofilitu, kter\u00e1 mu umo\u017e\u0148uje p\u0159ekonat hematoencefalickou bari\u00e9ru a p\u016fsobit preferen\u010dn\u011b na hladk\u00e9 svalstvo mozkov\u00fdch tepen. Polo\u010das v plazm\u011b 1-2 hodiny (kr\u00e1tk\u00fd) \u2014 vy\u017eaduje pod\u00e1v\u00e1n\u00ed ka\u017ed\u00e9 4 hodiny. Nimodipin NEN\u00cd obecn\u00e9 antihypertenzivum \u2014 pou\u017e\u00edv\u00e1 se speci\u00e1ln\u011b k <strong>prevenci opo\u017ed\u011bn\u00e9 mozkov\u00e9 ischemie (vazospazmu) po aneurysmatick\u00e9m subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed (aSAH)<\/strong>. D\u00e1vkov\u00e1n\u00ed: 60 mg peror\u00e1ln\u011b ka\u017ed\u00e9 4 hodiny po dobu 21 dn\u016f, zah\u00e1jeno do 96 hodin od krv\u00e1cen\u00ed. Pro hypertenzi pou\u017eijte <a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">amlodipin<\/a> nebo <a href=\"https:\/\/medsbase.com\/cs\/nicardia-retard\/\">nifedipin retard<\/a> Jak se fluoxetine porovn\u00e1v\u00e1 s dapoxetinem pro PE?.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Co je Nimodip?<\/h2>\n<p>Nimodip jsou peror\u00e1ln\u00ed tablety obsahuj\u00edc\u00ed 30 mg nimodipinu od v\u00fdrobce certifikovan\u00e9ho WHO-GMP, dod\u00e1van\u00e9 v balen\u00ed po 30-180 tablet\u00e1ch. Zaveden 1989 (Bayer jako <strong>Nimotop<\/strong>) speci\u00e1ln\u011b pro neurochirurgick\u00e9 pou\u017eit\u00ed. Na rozd\u00edl od ostatn\u00edch DHP m\u00e1 nimodipin vysokou lipofilitu, kter\u00e1 mu umo\u017e\u0148uje p\u0159ekonat hematoencefalickou bari\u00e9ru a p\u016fsobit preferen\u010dn\u011b na hladk\u00e9 svalstvo mozkov\u00fdch tepen.<\/p>\n<p>Nimodipin pat\u0159\u00ed mezi <strong>dihydropyridinov\u00fdch blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f<\/strong> , kter\u00e1 se odli\u0161uje od nedihydropyridin\u016f (<a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">diltiazem<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/calaptin-40\/\">verapamil<\/a>) sv\u00fdm <strong>selektivn\u00ed \u00fa\u010dinek na c\u00e9vn\u00ed hladk\u00e9 svalstvo s minim\u00e1ln\u00edm p\u0159\u00edm\u00fdm srde\u010dn\u00edm \u00fa\u010dinkem<\/strong>. Tento selektivn\u00ed profil je klinicky v\u00fdznamn\u00fd: DHP lze bezpe\u010dn\u011b kombinovat s beta-blok\u00e1tory (kombinace je standardn\u00ed u anginy pectoris), zat\u00edmco ne-DHP nikoli (riziko aditivn\u00ed bradykardie\/blok\u00e1dy srdce).<\/p>\n<h2 class=\"wp-block-heading\">Jak Nimodipin Funguje<\/h2>\n<p>Blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f se v\u00e1\u017eou na L-typ nap\u011b\u0165ov\u011b \u0159\u00edzen\u00fdch kalciov\u00fdch kan\u00e1l\u016f a sni\u017euj\u00ed vstup v\u00e1pn\u00edku do bu\u0148ky b\u011bhem depolarizace. V <strong>hladk\u00e9m svalstvu tepen<\/strong>, znamen\u00e1 sn\u00ed\u017een\u00fd vstup v\u00e1pn\u00edku m\u00e9n\u011b interakce aktin-myozin a <strong>p\u0159\u00edmou vazodilataci tepen<\/strong> \u2014 sn\u00ed\u017een\u00ed syst\u00e9mov\u00e9 c\u00e9vn\u00ed rezistence a krevn\u00edho tlaku.<\/p>\n<p>Dihydropyridiny jsou p\u0159ibli\u017en\u011b 10\u00d7 \u00fa\u010dinn\u011bj\u0161\u00ed na c\u00e9vn\u00ed hladk\u00e9 svalstvo ne\u017e na srde\u010dn\u00ed sval \u2013 dominantn\u00edm klinick\u00fdm \u00fa\u010dinkem je tedy vazodilatace s minim\u00e1ln\u00edm p\u0159\u00edm\u00fdm potla\u010den\u00edm srde\u010dn\u00ed kontraktility nebo veden\u00ed. Baroreflexn\u00ed odpov\u011b\u010f m\u016f\u017ee po rychle nastupuj\u00edc\u00ed vazodilataci vyvolat m\u00edrnou reflexn\u00ed tachykardii; nimodipin p\u016fsob\u00ed centr\u00e1ln\u011b na mozkov\u00e9 tepny, tak\u017ee reflexn\u00ed \u00fa\u010dinky jsou klinicky m\u00e9n\u011b v\u00fdznamn\u00e9.<\/p>\n<p>N\u00e1stup klinick\u00e9ho \u00fa\u010dinku: rychl\u00fd (15\u201330 minut); maxim\u00e1ln\u00ed plazmatick\u00e1 koncentrace do 1 hodiny.<\/p>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 a v\u011bdecky podlo\u017een\u00e9 indikace<\/h2>\n<ul>\n<li><strong>Aneuryzmatick\u00e9 subarachnoid\u00e1ln\u00ed krv\u00e1cen\u00ed (aSAH)<\/strong> \u2013 prevence opo\u017ed\u011bn\u00e9 mozkov\u00e9 ischemie zp\u016fsoben\u00e9 cerebr\u00e1ln\u00edm vazospazmem. 60 mg ka\u017ed\u00e9 4 hodiny po dobu 21 dn\u016f, za\u010d\u00e1tek pod\u00e1n\u00ed do 96 hodin.<\/li>\n<li><strong>Jin\u00e9 formy cerebr\u00e1ln\u00edho vazospazmu<\/strong> \u2013 neschv\u00e1len\u00e9 pou\u017eit\u00ed (po neurochirurgick\u00fdch v\u00fdkonech, traumatick\u00e9 SAH)<\/li>\n<li><strong>C\u00e9vn\u00ed kognitivn\u00ed porucha \/ m\u00edrn\u00e1 demence<\/strong> \u2014 mimo schv\u00e1len\u00e9 indikace; prom\u011bnliv\u00e1 evidence<\/li>\n<li><strong>Profylaxe migr\u00e9ny<\/strong> \u2014 mimo schv\u00e1len\u00e9 indikace; nikoli prvn\u00ed volba<\/ul>\n<p><strong>Kl\u00ed\u010dov\u00e9 d\u016fkazy z klinick\u00fdch studi\u00ed:<\/strong> <strong>British Aneurysm Nimodipine Trial (1989)<\/strong> a n\u00e1sledn\u00e1 potvrzen\u00ed \u2014 peror\u00e1ln\u00ed nimodipin 60 mg ka\u017ed\u00e9 4 hodiny po dobu 21 dn\u016f po aneurysmatick\u00e9m subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed (aSAH) sni\u017euje incidenci opo\u017ed\u011bn\u00e9 cerebr\u00e1ln\u00ed ischemie (z vasospasmu) a zlep\u0161uje neurologick\u00fd v\u00fdsledek. Toto z\u016fst\u00e1v\u00e1 JEDIN\u00ddM prok\u00e1zan\u00fdm farmakologick\u00fdm z\u00e1sahem ke sn\u00ed\u017een\u00ed morbidity souvisej\u00edc\u00ed s vasospasmem u aSAH.<\/p>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed Nimodipu<\/h2>\n<p><strong>Hlavn\u00ed indikace \u2014 prevence vasospasmu u aSAH:<\/strong><\/p>\n<ul>\n<li><strong>60 mg peror\u00e1ln\u011b ka\u017ed\u00e9 4 hodiny po dobu 21 dn\u016f<\/strong>, za\u010d\u00ednaj\u00edc\u00ed do 96 hodin od diagn\u00f3zy subarachnoid\u00e1ln\u00edho krv\u00e1cen\u00ed<\/li>\n<li>U intubovan\u00fdch\/nedostupn\u00fdch pacient\u016f: stejn\u00e1 d\u00e1vka pomoc\u00ed nazogastrick\u00e9 sondy<\/li>\n<li>P\u0159i jatern\u00edm po\u0161kozen\u00ed sn\u00ed\u017eit na 30 mg ka\u017ed\u00e9 4 hodiny<\/li>\n<li>P\u0159eru\u0161it, pokud systolick\u00fd TK klesne pod 100 mmHg; agresivn\u00ed volumov\u00e1 n\u00e1hrada k udr\u017een\u00ed cerebr\u00e1ln\u00edho perfuzn\u00edho tlaku je obvykl\u00e1 na neurochirurgick\u00fdch jednotk\u00e1ch<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>\u010cast\u00e9 (&gt;5%, v\u011bt\u0161inou m\u00edrn\u00e9 a p\u0159echodn\u00e9):<\/strong><\/p>\n<ul>\n<li>Hypotenze (hlavn\u00ed obava p\u0159i akutn\u00edm neurochirurgick\u00e9m pou\u017eit\u00ed)<\/li>\n<li>N\u00e1valy horka (teplo v obli\u010deji a horn\u00ed \u010d\u00e1sti t\u011bla)<\/li>\n<li>Bolest hlavy (zejm\u00e9na na za\u010d\u00e1tku terapie; obvykle se p\u0159izp\u016fsob\u00ed b\u011bhem 2-4 t\u00fddn\u016f)<\/li>\n<li>Reflexn\u00ed tachykardie (palpitace) \u2014 m\u00e9n\u011b \u010dast\u00e1 u dlouhodob\u011b p\u016fsob\u00edc\u00edch forem<\/li>\n<li>Z\u00e1vrat\u011b, ortostatick\u00e1 hypotenze<\/li>\n<li>\u00danava<\/li>\n<li>M\u00edrn\u00e1 z\u00e1cpa (m\u00e9n\u011b ne\u017e u ne-DHP)<\/li>\n<\/ul>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9:<\/strong><\/p>\n<ul>\n<li>Vyr\u00e1\u017eka, sv\u011bd\u011bn\u00ed<\/li>\n<li>Nevolnost, b\u0159i\u0161n\u00ed dyskomfort<\/li>\n<li>Erektiln\u00ed dysfunkce (vz\u00e1cn\u011b)<\/li>\n<li>Zv\u00fd\u0161en\u00ed jatern\u00edch enzym\u016f (obvykle m\u00edrn\u00e9, reverzibiln\u00ed)<\/li>\n<li>Vz\u00e1cn\u00e9 hl\u00e1\u0161en\u00e9 p\u0159\u00edpady fotosenzitivity<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace a upozorn\u011bn\u00ed<\/h2>\n<ul>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na nimodipin nebo t\u0159\u00eddu dihydropyridin\u016f<\/li>\n<li>Kardiogenn\u00ed \u0161ok<\/li>\n<li>T\u011b\u017ek\u00e1 aort\u00e1ln\u00ed sten\u00f3za (m\u016f\u017ee zp\u016fsobit kritickou hypotenzi)<\/li>\n<li>Nestabiln\u00ed angina pectoris nebo infarkt myokardu do 1 m\u011bs\u00edce (DHP krom\u011b amlodipinu)<\/li>\n<li>Obstruk\u010dn\u00ed hypertrofick\u00e1 kardiomyopatie (dynamicky sni\u017euje v\u00fdtokov\u00fd gradient)<\/li>\n<li>T\u011b\u017ek\u00e9 po\u0161kozen\u00ed jater (v\u0161echny DHP jsou metabolizov\u00e1ny j\u00e1try)<\/li>\n<\/ul>\n<p><strong>T\u011bhotenstv\u00ed:<\/strong> vyhnout se nimodipinu, pokud nen\u00ed absolutn\u011b nutn\u00fd u aSAH (kde p\u0159\u00ednos p\u0159eva\u017euje riziko).<\/p>\n<p><strong>Kojen\u00ed:<\/strong> mal\u00e9 mno\u017estv\u00ed v mate\u0159sk\u00e9m ml\u00e9ce; obecn\u011b pova\u017eov\u00e1no za p\u0159ijateln\u00e9 s monitorov\u00e1n\u00edm kojence.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Grapefruitov\u00e1 \u0161\u0165\u00e1va<\/strong> \u2014 inhibuje metabolismus CYP3A4; m\u016f\u017ee zv\u00fd\u0161it plazmatick\u00e9 hladiny amlodipinu a zejm\u00e9na nifedipinu\/nimodipinu 2\u20133\u00d7. Vyvarujte se u\u017e\u00edv\u00e1n\u00ed v l\u00e9\u010debn\u00e9 dny, nebo u\u017e\u00edvejte konzistentn\u011b, pokud v\u016fbec.<\/li>\n<li><strong>Siln\u00e9 inhibitory CYP3A4<\/strong> (ketokonazol, itrakonazol, klarithromycin, ritonavir, kobicistat) \u2014 zvy\u0161uj\u00ed plazmatick\u00e9 hladiny BKK; sni\u017ete d\u00e1vku nebo se vyhn\u011bte<\/li>\n<li><strong>Siln\u00e9 induktory CYP3A4<\/strong> (rifampicin, fenytoin, karbamazepin, t\u0159ezalka te\u010dkovan\u00e1) \u2014 sni\u017euj\u00ed plazmatick\u00e9 hladiny BKK; m\u016f\u017ee b\u00fdt nutn\u00e9 zv\u00fd\u0161it d\u00e1vku<\/li>\n<li><strong>Simvastatin<\/strong> \u2014 amlodipin m\u00edrn\u011b zvy\u0161uje expozici simvastatinu; omezte simvastatin na 20 mg\/den p\u0159i kombinaci<\/li>\n<li><strong>Beta-blok\u00e1tory<\/strong> \u2014 DHP lze kombinovat <strong>bezpe\u010dn\u011b<\/strong> s betablok\u00e1tory (kombinace je standardem u anginy pectoris \u2014 betablok\u00e1tor tlum\u00ed reflexn\u00ed tachykardii, BKK zaji\u0161\u0165uje vazodilataci). Na rozd\u00edl od ne-DHP BKK (diltiazem, verapamil), kter\u00e9 by se s betablok\u00e1tory NEM\u011aLY kombinovat.<\/li>\n<li><strong>Jin\u00e1 antihypertenziva<\/strong> \u2014 obecn\u011b komplement\u00e1rn\u00ed; monitorujte TK<\/li>\n<li><strong>Sildenafil \/ tadalafil<\/strong> (Inhibitory PDE5 pro erektiln\u00ed dysfunkci) \u2014 aditivn\u00ed hypotenze; opatrnost zejm\u00e9na p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch CCB<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">P\u0159ehled t\u0159\u00eddy blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">CCB<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">T\u0159\u00edda<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Niche<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">Amlodipin (Amlode, Amlip)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (3. generace)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Referen\u010dn\u00ed DHP; jednou denn\u011b pro hypertenzi a anginu pectoris; d\u016fkazy ze studie ASCOT<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/depin\/\">Nifedipin (Depin, Nicardia Retard, Cardipin)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (1. generace)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed MR; tokol\u00fdza; pro chronickou hypertenzi nutno pou\u017e\u00edt ER formulace<\/td>\n<\/tr>\n<tr style=\"background:#fff3cd;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/nimodip-nimodipine\/\">Nimodipin (Nimodip)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">DHP (cerebrovaskul\u00e1rn\u00ed)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Prevence vazospazmu p\u0159i subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed \u2014 NEPOU\u017d\u00cdVAT pro b\u011b\u017enou hypertenzi<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">Diltiazem (Dilzem, Dilzem CD)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Non-DHP (benzothiazepin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">HTN + kontrola srde\u010dn\u00ed frekvence + angina; st\u0159edn\u00ed srde\u010dn\u00ed \u00fa\u010dinek<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><a href=\"https:\/\/medsbase.com\/cs\/calaptin-40\/\">Verapamil (Calaptin 40, Calaptin SR)<\/a><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Non-DHP (fenylalkylamin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Nejsiln\u011bj\u0161\u00ed srde\u010dn\u00ed \u00fa\u010dinek; SVT, kontrola frekvence p\u0159i AF, cluster headache<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>DHP vs non-DHP \u2014 pro\u010d na tom z\u00e1le\u017e\u00ed:<\/strong> DHP (amlodipin, nifedipin) selektivn\u011b p\u016fsob\u00ed na arteri\u00e1ln\u00ed hladk\u00e9 svalstvo s minim\u00e1ln\u00edm srde\u010dn\u00edm \u00fa\u010dinkem \u2014 lze bezpe\u010dn\u011b kombinovat s betablok\u00e1tory. Non-DHP (diltiazem, verapamil) zpomaluj\u00ed AV nod\u00e1ln\u00ed veden\u00ed a sni\u017euj\u00ed srde\u010dn\u00ed kontraktilitu \u2014 <strong>NEKOMBINUJTE s betablok\u00e1tory<\/strong> (riziko aditivn\u00ed bradykardie, srde\u010dn\u00edho bloku a akutn\u00edho srde\u010dn\u00edho selh\u00e1n\u00ed). Pokud pacient ji\u017e u\u017e\u00edv\u00e1 betablok\u00e1tor, pou\u017eijte DHP.<\/p>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Skladujte Nimodip p\u0159i teplot\u011b pod 25\u00b0C. Chra\u0148te p\u0159ed sv\u011btlem. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Mohu j\u00edst grapefruit p\u0159i u\u017e\u00edv\u00e1n\u00ed Nimodipu?<\/h3>\n<p>Grapefruit (\u0161\u0165\u00e1va i \u010derstv\u00e9 ovoce) inhibuje metabolismus CYP3A4 a m\u016f\u017ee zv\u00fd\u0161it hladinu nimodipinu v plazm\u011b 2-3\u00d7, co\u017e zvy\u0161uje riziko hypotenze, z\u00e1vrat\u00ed a otok\u016f. Doporu\u010den\u00fd postup: vyhn\u011bte se grapefruitu\/\u0161\u0165\u00e1v\u011b p\u0159i u\u017e\u00edv\u00e1n\u00ed blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f (CCB), nebo jej konzumujte konzistentn\u011b (d\u00e1vkov\u00e1n\u00ed je titrov\u00e1no podle krevn\u00edho tlaku; ob\u010dasn\u00e1 konzumace grapefruitu to naru\u0161uje).<\/p>\n<h3 class=\"wp-block-heading\">Je Nimodip bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed?<\/h3>\n<p>Nimodipin se v t\u011bhotenstv\u00ed vyh\u00fdb\u00e1, krom\u011b \u017eivot ohro\u017euj\u00edc\u00edho aneurysmatick\u00e9ho subarachnoid\u00e1ln\u00edho krv\u00e1cen\u00ed (aSAH), kde neurologick\u00fd p\u0159\u00ednos p\u0159eva\u017euje nad rizikem expozice plodu.<\/p>\n<h3 class=\"wp-block-heading\">Mohu kombinovat Nimodip se sv\u00fdmi dal\u0161\u00edmi l\u00e9ky na krevn\u00ed tlak?<\/h3>\n<p>Ano \u2014 DHP blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f se dob\u0159e kombinuj\u00ed s <strong>ACE inhibitory<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/ramcor\/\">ramipril<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/lispro\/\">lisinoprilem<\/a>), <strong>sartany<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/losar\/\">losartan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/telmaheal\/\">telmisartan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/olmin\/\">olmesartan<\/a>), <strong>beta-blok\u00e1tory<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/concor\/\">bisoprolol<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/betablock-xl\/\">metoprolol<\/a>), a <strong>thiazidov\u00fdmi diuretiky<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">HCTZ<\/a>). Kombinace ACE inhibitoru\/sartanu + blok\u00e1toru kalciov\u00fdch kan\u00e1l\u016f je obzvl\u00e1\u0161t\u011b u\u017eite\u010dn\u00e1, proto\u017ee eliminuje vedlej\u0161\u00ed \u00fa\u010dinek v podob\u011b otoku kotn\u00edk\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Mohu pou\u017e\u00edvat nimodipin na b\u011b\u017enou hypertenzi?<\/h3>\n<p>Ne \u2013 nimodipin je specializovan\u00fd neurochirurgick\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f (CCB), pou\u017e\u00edvan\u00fd v 21denn\u00edch k\u00far\u00e1ch k prevenci cerebr\u00e1ln\u00edho vazospasmu po subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed. Jeho kr\u00e1tk\u00fd polo\u010das vy\u017eaduje d\u00e1vkov\u00e1n\u00ed ka\u017ed\u00e9 4 hodiny, co\u017e je pro chronickou hypertenzi nepraktick\u00e9, a jeho cerebrovaskul\u00e1rn\u00ed selektivita z n\u011bj \u010din\u00ed m\u00e9n\u011b \u00fa\u010dinn\u00fd l\u00e9k na perifern\u00ed kontrolu krevn\u00edho tlaku ve srovn\u00e1n\u00ed s amlodipinem nebo nifedipinem MR. Pou\u017e\u00edvejte <a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">amlodipin<\/a> nebo <a href=\"https:\/\/medsbase.com\/cs\/nicardia-retard\/\">nifedipin retard<\/a> pro chronickou hypertenzi.<\/p>\n<h3 class=\"wp-block-heading\">Kde si mohu koupit Nimodip online?<\/h3>\n<p>Nimodip (nimodipin 30 mg, 30-180 tablet) si m\u016f\u017eete koupit na MedsBase s diskr\u00e9tn\u00edm balen\u00edm a celosv\u011btovou dopravou.<\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed antihypertenziva na MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">Aquazide \u2014 diuretikum hydrochlorothiazid<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/calaptin-sr\/\">Calaptin SR \u2014 Verapamil SR 120\/240 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cardipin-retard\/\">Cardipin Retard \u2014 Nifedipin 20 mg ER<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">Dilzem \u2014 Diltiazem IR 30\/60 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/dilzem-cd\/\">Dilzem CD \u2014 diltiazem CD 120\/180 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/nicardia-retard\/\">Nicardia Retard \u2014 Nifedipin retard 10\/20\/30 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/high-blood-pressure-medication\/\"><strong>Prohl\u00e9dnout v\u0161echny l\u00e9ky na vysok\u00fd krevn\u00ed tlak<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho zdravotnick\u00e9ho pracovn\u00edka. Hypertenze, srde\u010dn\u00ed selh\u00e1n\u00ed a arytmie vy\u017eaduj\u00ed diagn\u00f3zu, monitorov\u00e1n\u00ed a individu\u00e1ln\u00ed d\u00e1vkov\u00e1n\u00ed l\u00e9ka\u0159em \u2014 v\u017edy u\u017e\u00edvejte betablok\u00e1tory pod l\u00e9ka\u0159sk\u00fdm dohledem.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cerecetam\/\">Cerecetam<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/aquazide\/\">Aquazide<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/natrilix-sr\/\">Natrilix SR<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/avil-25\/\">Avil 25<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tamoxilon\/\">Tamoxilon<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Nimodip jsou tablety obsahuj\u00edc\u00ed 30 mg nimodipinu \u2014 cerebrovaskul\u00e1rn\u011b selektivn\u00ed dihydropyridinov\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f (BKK). PRIM\u00c1RN\u00cd INDIKACE: prevence opo\u017ed\u011bn\u00e9 mozkov\u00e9 ischemie zp\u016fsoben\u00e9 vazospazmem po aneurysmatick\u00e9m subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed (aSAH). Standardn\u00ed re\u017eim: 60 mg ka\u017ed\u00e9 4 hodiny po dobu 21 dn\u016f, zah\u00e1jeno do 96 hodin od krv\u00e1cen\u00ed (British Aneurysm Nimodipine Trial). Nen\u00ed ur\u010deno pro rutinn\u00ed l\u00e9\u010dbu hypertenze \u2014 m\u00edsto toho pou\u017eijte amlodipin nebo retardovan\u00fd nifedipin.<\/p>","protected":false},"featured_media":55257,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3892,3893],"class_list":{"0":"post-55256","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-heart-blood-pressure","9":"product_cat-high-blood-pressure-medication","10":"product_tag-nimodip","11":"product_tag-nimodipine","13":"first","14":"instock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/55256","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=55256"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/55257"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=55256"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=55256"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=55256"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=55256"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}