{"id":59456,"date":"2024-02-28T05:59:00","date_gmt":"2024-02-28T05:59:00","guid":{"rendered":"https:\/\/medsname.com\/nimodip\/"},"modified":"2026-05-01T10:49:15","modified_gmt":"2026-05-01T10:49:15","slug":"nimodip","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/nimodip\/","title":{"rendered":"Nimodip"},"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 peror\u00e1ln\u00ed <strong>nimodipin<\/strong> (30 mg) tableta \u2014 <strong>cerebr\u00e1ln\u011b selektivn\u00ed dihydropyridinov\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f<\/strong> specificky ur\u010den\u00fd k prevenci a sn\u00ed\u017een\u00ed z\u00e1va\u017enosti <strong>mozkov\u00e9ho vazospazmu<\/strong> a <strong>oplo\u017ed\u011bn\u00e9 mozkov\u00e9 ischemie (DCI)<\/strong> po <strong>aneuryzmatick\u00e9m subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed (aSAH)<\/strong>. D\u00e1vkov\u00e1n\u00ed: <strong>60 mg ka\u017ed\u00e9 4 hodiny (360 mg\/den) po dobu 21 po sob\u011b jdouc\u00edch dn\u016f<\/strong>, zah\u00e1jeno do 96 hodin od krv\u00e1cen\u00ed. Nimodipin preferen\u010dn\u011b roz\u0161i\u0159uje mozkov\u00e9 tepny oproti perifern\u00edm, \u010d\u00edm\u017e sni\u017euje v\u00fdskyt neurologick\u00fdch deficit\u016f souvisej\u00edc\u00edch s vazospazmem, ani\u017e by zp\u016fsoboval v\u00fdznamnou syst\u00e9movou hypotenzi p\u0159i standardn\u00edch d\u00e1vk\u00e1ch. \u010cast\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky: hypotenze, bolest hlavy, nevolnost, n\u00e1valy horka.<\/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 je peror\u00e1ln\u00ed tableta obsahuj\u00edc\u00ed <strong>nimodipin 30 mg<\/strong>. Nimodipin je <strong>cerebr\u00e1ln\u011b selektivn\u00ed dihydropyridinov\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f<\/strong> \u2014 na rozd\u00edl od jin\u00fdch blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f (amlodipin, nifedipin) preferen\u010dn\u011b roz\u0161i\u0159uje mozkov\u00e9 tepny s minim\u00e1ln\u00edm \u00fa\u010dinkem na perifern\u00ed krevn\u00ed tlak.<\/p>\n<p>Nimodipin je <strong>jedin\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f s neurologickou indikac\u00ed<\/strong>: prevence ischemick\u00fdch neurologick\u00fdch deficit\u016f (vazospazmus) po aneurysmatick\u00e9m <strong>subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed (SAH)<\/strong>. Kl\u00ed\u010dov\u00e1 studie BIDA (1983) prok\u00e1zala ~40% sn\u00ed\u017een\u00ed v\u00fdskytu mozkov\u00e9ho infarktu a lep\u0161\u00ed neurologick\u00e9 v\u00fdsledky p\u0159i standardn\u00edm 21denn\u00edm peror\u00e1ln\u00edm pod\u00e1v\u00e1n\u00ed. Nimodip je vyr\u00e1b\u011bn ve v\u00fdrobn\u00edm z\u00e1vod\u011b certifikovan\u00e9m WHO-GMP a je bioekvivalentn\u00ed origin\u00e1ln\u00ed zna\u010dce <strong>Nimotop<\/strong> (Bayer).<\/p>\n<h2 class=\"wp-block-heading\">Jak Nimodip (Nimodipin) Funguje?<\/h2>\n<p>Nimodipin blokuje <strong>nap\u011b\u0165ov\u011b \u0159\u00edzen\u00e9 kalciov\u00e9 kan\u00e1ly typu L<\/strong>, ale na rozd\u00edl od jin\u00fdch blok\u00e1tor\u016f kalciov\u00fdch kan\u00e1l\u016f (amlodipin, nifedipin) m\u00e1 <strong>preferen\u010dn\u00ed afinitu k hladk\u00e9mu svalstvu mozkov\u00fdch c\u00e9v<\/strong>. Tato mozkov\u00e1 selektivita znamen\u00e1, \u017ee roz\u0161i\u0159uje mozkov\u00e9 tepny v\u00edce ne\u017e perifern\u00ed, co\u017e jej \u010din\u00ed jedine\u010dn\u011b vhodn\u00fdm pro prevenci vazospazmu po subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed.<\/p>\n<p>Krom\u011b vazodilatace m\u016f\u017ee m\u00edt nimodipin <strong>neuroprotektivn\u00ed \u00fa\u010dinky<\/strong> \u2014 sni\u017euje vstup v\u00e1pn\u00edku do neuron\u016f b\u011bhem ischemie, co\u017e zm\u00edr\u0148uje excitotoxickou bun\u011b\u010dnou smrt. Klinick\u00e9 studie (pr\u016flomov\u00e1 British Aneurysm Nimodipine Trial) prok\u00e1zaly v\u00fdznamn\u00e9 sn\u00ed\u017een\u00ed \u0161patn\u00fdch v\u00fdsledk\u016f, p\u0159esto\u017ee m\u00edry angiografick\u00e9ho vasospasmu nebyly dramaticky odli\u0161n\u00e9 \u2014 co\u017e nazna\u010duje, \u017ee p\u0159\u00ednos je \u010d\u00e1ste\u010dn\u011b neuroprotektivn\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Indikace<\/h2>\n<ul>\n<li><strong>Prevence mozkov\u00e9ho vasospasmu<\/strong> a opo\u017ed\u011bn\u00e9 mozkov\u00e9 ischemie po aneurysmatick\u00e9m subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed \u2014 jedin\u00e9 schv\u00e1len\u00e9 indikace <strong>jedin\u00e1 schv\u00e1len\u00e1 indikace<\/strong><\/li>\n<li><strong>Neschv\u00e1len\u00e9 pou\u017eit\u00ed:<\/strong> profylaxe migr\u00e9ny, vaskul\u00e1rn\u00ed demence (omezen\u00e9 d\u016fkazy), traumatick\u00e9 subarachnoid\u00e1ln\u00ed krv\u00e1cen\u00ed<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed \u2014 21denn\u00ed protokol<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:0 0 24px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px 14px;\">Parametr<\/th>\n<th style=\"padding:10px 14px;\">Standardn\u00ed protokol<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px 14px;\">D\u00e1vka<\/td>\n<td style=\"padding:10px 14px;\">60 mg (dv\u011b tablety po 30 mg)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px 14px;\">Frekvence<\/td>\n<td style=\"padding:10px 14px;\">Ka\u017ed\u00e9 4 hodiny<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px 14px;\">Celkov\u00e1 denn\u00ed d\u00e1vka<\/td>\n<td style=\"padding:10px 14px;\">360 mg\/den<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px 14px;\">D\u00e9lka<\/td>\n<td style=\"padding:10px 14px;\">21 po sob\u011b jdouc\u00edch dn\u016f<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px 14px;\">Start<\/td>\n<td style=\"padding:10px 14px;\">Do 96 hodin po krv\u00e1cen\u00ed<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px 14px;\">Porucha funkce jater<\/td>\n<td style=\"padding:10px 14px;\">30 mg ka\u017ed\u00e9 4 hodiny (polovi\u010dn\u00ed d\u00e1vka)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Kritick\u00e9:<\/strong> Tablety Nimodipinu mus\u00ed b\u00fdt <strong>polyk\u00e1ny vcelku<\/strong>, nerozdrcen\u00e9. U pacient\u016f, kte\u0159\u00ed nemohou polykat, lze obsah extrahovat pomoc\u00ed st\u0159\u00edka\u010dky a podat nasogastrickou sondou \u2014 av\u0161ak <strong>nikdy nepod\u00e1vejte peror\u00e1ln\u00ed roztok intraven\u00f3zn\u011b<\/strong> (do\u0161lo k fat\u00e1ln\u00edm p\u0159\u00edpad\u016fm ne\u00famysln\u00e9ho intraven\u00f3zn\u00edho pod\u00e1n\u00ed peror\u00e1ln\u00edho nimodipinu). U\u017e\u00edvejte nejm\u00e9n\u011b 1 hodinu p\u0159ed j\u00eddlem nebo 2 hodiny po j\u00eddle pro optim\u00e1ln\u00ed absorpci.<\/p>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>\u010cast\u00e9:<\/strong> hypotenze (d\u00e1vkov\u011b z\u00e1visl\u00e1, obvykle m\u00edrn\u00e1), bolest hlavy, nevolnost, n\u00e1valy horka, perifern\u00ed ed\u00e9m.<\/p>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9:<\/strong> z\u00e1vrat\u011b, tachykardie, vyr\u00e1\u017eka, gastrointestin\u00e1ln\u00ed pot\u00ed\u017ee, bradykardie.<\/p>\n<p><strong>Z\u00e1va\u017en\u00e9:<\/strong> t\u011b\u017ek\u00e1 hypotenze (zejm\u00e9na u pacient\u016f s p\u0159edchoz\u00edm n\u00edzk\u00fdm krevn\u00edm tlakem nebo u\u017e\u00edvaj\u00edc\u00edch jin\u00e1 antihypertenziva), ileus (u kriticky nemocn\u00fdch pacient\u016f s SAH), hepatotoxicita (vz\u00e1cn\u00e9 \u2014 zv\u00fd\u0161en\u00e9 transamin\u00e1zy).<\/p>\n<h2 class=\"wp-block-heading\">Varov\u00e1n\u00ed a opat\u0159en\u00ed<\/h2>\n<ul>\n<li><strong>Hypotenze.<\/strong> Nimodipin m\u016f\u017ee zp\u016fsobit v\u00fdznamn\u00e9 poklesy krevn\u00edho tlaku, zejm\u00e9na u hypovolemick\u00fdch pacient\u016f s SAH nebo u t\u011bch, kte\u0159\u00ed u\u017e\u00edvaj\u00ed jin\u00e1 antihypertenziva. Monitorujte TK ka\u017ed\u00fdch 1\u20132 hodiny b\u011bhem prvn\u00edch 48 hodin. Sni\u017ete d\u00e1vku na 30 mg ka\u017ed\u00e9 4 hodiny (m\u00edsto ka\u017ed\u00fdch 2 hodin), pokud systolick\u00fd tlak klesne pod 90 mmHg.<\/li>\n<li><strong>Jatern\u00ed porucha.<\/strong> Nimodipin podl\u00e9h\u00e1 rozs\u00e1hl\u00e9mu prvopr\u016fchodov\u00e9mu jatern\u00edmu metabolismu. U cirh\u00f3zy se biologick\u00e1 dostupnost v\u00fdrazn\u011b zvy\u0161uje \u2014 d\u00e1vku sni\u017ete na polovinu a monitorujte hypotenzi a bradykardii.<\/li>\n<li><strong>Mozkov\u00fd ed\u00e9m \/ zv\u00fd\u0161en\u00fd nitrolebn\u00ed tlak.<\/strong> Pou\u017e\u00edvejte opatrn\u011b u pacient\u016f s mozkov\u00fdm ed\u00e9mem nebo v\u00fdrazn\u011b zv\u00fd\u0161en\u00fdm nitrolebn\u00edm tlakem.<\/li>\n<li><strong>Grapefruitov\u00fd d\u017eus.<\/strong> Inhibuje metabolismus nimodipinu CYP3A4, \u010d\u00edm\u017e zdvojn\u00e1sobuje plazmatick\u00e9 hladiny. B\u011bhem 21denn\u00edho protokolu se vyhn\u011bte grapefruitov\u00fdm produkt\u016fm.<\/li>\n<li><strong>Epilepsie.<\/strong> Pod\u00e1vejte nimodipin opatrn\u011b u pacient\u016f s epilepsi\u00ed \u2014 a\u010dkoli nen\u00ed epileptogenn\u00ed, z\u00e1chvaty jsou \u010dastou komplikac\u00ed SAH a l\u00e9kov\u00e9 interakce s antikonvulzivy (zejm\u00e9na enzymov\u00fdmi induktory jako fenytoin a karbamazepin) jsou klinicky v\u00fdznamn\u00e9.<\/li>\n<li><strong>T\u011bhotensk\u00e1 kategorie C.<\/strong> Teratogenn\u00ed u zv\u00ed\u0159at p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch. Pou\u017e\u00edvejte pouze v p\u0159\u00edpad\u011b, kdy p\u0159\u00ednos p\u0159ev\u00e1\u017e\u00ed riziko.<\/li>\n<li><strong>Kojen\u00ed.<\/strong> Nimodipin se vylu\u010duje do mate\u0159sk\u00e9ho ml\u00e9ka. Klinick\u00fd v\u00fdznam je nejist\u00fd \u2014 pou\u017e\u00edvejte opatrn\u011b.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace \u2014 Kdo by NEM\u011aL u\u017e\u00edvat Nimodip<\/h2>\n<ul>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na nimodipin, jin\u00e9 dihydropyridiny nebo jakoukoli pomocnou l\u00e1tku<\/li>\n<li>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed s <strong>rifampicinem<\/strong> (sni\u017euje hladiny nimodipinu na podterapeutick\u00e9 indukc\u00ed CYP3A4)<\/li>\n<li>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed s <strong>siln\u00fdmi inhibitory CYP3A4<\/strong> (ketokonazol, itrakonazol, ritonavir) bez sn\u00ed\u017een\u00ed d\u00e1vky<\/li>\n<li>Nestabiln\u00ed angina pectoris nebo ned\u00e1vn\u00fd IM (do 4 t\u00fddn\u016f)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Jin\u00e1 antihypertenziva a blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f:<\/strong> Aditivn\u00ed hypotenze<\/li>\n<li><strong>Inhibitory CYP3A4<\/strong> (ketokonazol, flukonazol, makrolidov\u00e1 antibiotika, grapefruitov\u00fd d\u017eus): V\u00fdznamn\u011b zvy\u0161uj\u00ed hladinu nimodipinu<\/li>\n<li><strong>Induktory CYP3A4<\/strong> (rifampicin, fenytoin, karbamazepin, fenobarbital): Sni\u017euj\u00ed hladinu nimodipinu, potenci\u00e1ln\u011b na subterapeutickou<\/li>\n<li><strong>Betablok\u00e1tory:<\/strong> Aditivn\u00ed negativn\u00ed chronotropn\u00ed \u00fa\u010dinek \u2014 monitorujte srde\u010dn\u00ed frekvenci<\/li>\n<li><strong>Nefrotoxick\u00e9 l\u00e9ky:<\/strong> Nimodipin m\u016f\u017ee zhor\u0161it ren\u00e1ln\u00ed funkci u pacient\u016f se SAH l\u00e9\u010den\u00fdch sou\u010dasn\u011b nefrotoxiky<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Pokyny k uchov\u00e1v\u00e1n\u00ed<\/h2>\n<ul>\n<li>Skladujte p\u0159i pokojov\u00e9 teplot\u011b, <strong>15\u201325\u00b0C<\/strong>. <strong>Chra\u0148te p\u0159ed sv\u011btlem<\/strong> \u2014 nimodipin je citliv\u00fd na sv\u011btlo.<\/li>\n<li>Uchov\u00e1vejte v p\u016fvodn\u00edm obalu z hn\u011bd\u00e9ho blisteru a\u017e do pou\u017eit\u00ed.<\/li>\n<li>Neskladujte v koupeln\u011b.<\/li>\n<li>Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/li>\n<li>Nepou\u017e\u00edvejte po uplynut\u00ed data expirace.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed kategorie na MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/neurological-conditions-and-epilepsy\/\">Prohl\u00e9dn\u011bte si v\u0161echny neurologick\u00e9 a antiepileptick\u00e9 l\u00e9ky<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/heart-and-blood-pressure\/\">Prohl\u00e9dn\u011bte si l\u00e9ky na srdce a krevn\u00ed tlak<\/a><\/li>\n<\/ul>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">K \u010demu se Nimodip pou\u017e\u00edv\u00e1?<\/h3>\n<p>Nimodip obsahuje <strong>nimodipin 30 mg<\/strong> a pou\u017e\u00edv\u00e1 se k prevenci <strong>mozkov\u00e9ho vazospazmu<\/strong> a <strong>opo\u017ed\u011bn\u00e9 mozkov\u00e9 isch\u00e9mie<\/strong> po aneurysmatick\u00e9m subarachnoid\u00e1ln\u00edm krv\u00e1cen\u00ed (aSAH). Je to jedin\u00fd l\u00e9k prok\u00e1zan\u011b zlep\u0161uj\u00edc\u00ed neurologick\u00e9 v\u00fdsledky po SAH.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d se nimodipin pod\u00e1v\u00e1 ka\u017ed\u00e9 4 hodiny a ne dvakr\u00e1t denn\u011b?<\/h3>\n<p>Nimodipin m\u00e1 kr\u00e1tk\u00fd polo\u010das (<strong>za 1\u20132 hodiny<\/strong> p\u0159i peror\u00e1ln\u00edm pod\u00e1n\u00ed). Pod\u00e1v\u00e1n\u00ed ka\u017ed\u00e9 4 hodiny zaji\u0161\u0165uje kontinu\u00e1ln\u00ed terapeutick\u00e9 hladiny b\u011bhem 21denn\u00edho kritick\u00e9ho obdob\u00ed vazospazm\u016f (nejvy\u0161\u0161\u00ed riziko je mezi 3.\u201314. dnem). Vynech\u00e1n\u00ed d\u00e1vek vytv\u00e1\u0159\u00ed mezery v ochran\u011b.<\/p>\n<h3 class=\"wp-block-heading\">Je nimodipin stejn\u00fd jako nifedipin nebo amlodipin?<\/h3>\n<p>V\u0161echny t\u0159i jsou dihydropyridinov\u00e9 blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f, ale nimodipin je <strong>jedine\u010dn\u011b selektivn\u00ed pro mozek<\/strong>. Nifedipin a amlodipin prim\u00e1rn\u011b p\u016fsob\u00ed na perifern\u00ed a koron\u00e1rn\u00ed tepny a pou\u017e\u00edvaj\u00ed se pro hypertenzi\/anginu pectoris. Nejsou <strong>zam\u011bniteln\u00e9<\/strong> \u2014 pouze nimodipin m\u00e1 prok\u00e1zan\u00fd \u00fa\u010dinek na v\u00fdsledky SAH.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d se nimodipin nikdy nesm\u00ed pod\u00e1vat intraven\u00f3zn\u011b?<\/h3>\n<p>Peror\u00e1ln\u00ed formy nimodipinu obsahuj\u00ed pomocn\u00e9 l\u00e1tky nevhodn\u00e9 pro IV injekci. N\u00e1hodn\u00e9 nitro\u017eiln\u00ed pod\u00e1n\u00ed zp\u016fsobilo <strong>kardiovaskul\u00e1rn\u00ed kolaps a smrt<\/strong>. Pokud nen\u00ed mo\u017en\u00e9 pod\u00e1vat peror\u00e1ln\u011b (pacienti v bezv\u011bdom\u00ed), m\u011bl by se nimodipin pod\u00e1vat pomoc\u00ed nasogastrick\u00e9 sondy, nikoli injek\u010dn\u011b.<\/p>\n<h3 class=\"wp-block-heading\">Zabra\u0148uje nimodipin skute\u010dn\u011b vazospazmu?<\/h3>\n<p>Zaj\u00edmav\u00e9 je, \u017ee nimodipin <strong>v\u00fdznamn\u011b nesni\u017euje angiografick\u00fd vazospazmus<\/strong>. Jeho p\u0159\u00ednos se zd\u00e1 b\u00fdt p\u0159edev\u0161\u00edm <strong>neuroprotektivn\u00ed<\/strong> \u2014 sni\u017euje ischemick\u00e9 po\u0161kozen\u00ed neuron\u016f zp\u016fsoben\u00e9 vazospazmem, nikoli v\u0161ak samotn\u00fd spazmus. Klinick\u00fdm v\u00fdsledkem je m\u00e9n\u011b pacient\u016f s trval\u00fdmi neurologick\u00fdmi deficity.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat nimodipin s grapefruitov\u00fdm d\u017eusem?<\/h3>\n<p><strong>Ne.<\/strong> Grapefruitov\u00fd d\u017eus inhibuje CYP3A4, co\u017e v\u00fdznamn\u011b zvy\u0161uje hladiny nimodipinu a riziko hypotenze. B\u011bhem l\u00e9\u010dby se grapefruitov\u00e9mu d\u017eusu vyh\u00fdbejte.<\/p>\n<h3 class=\"wp-block-heading\">Co se stane, kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n<p>Vynechanou d\u00e1vku u\u017eijte co nejd\u0159\u00edve. Pokud se bl\u00ed\u017e\u00ed \u010das dal\u0161\u00ed d\u00e1vky, vynechanou vynechejte a pokra\u010dujte v pl\u00e1nu. Vzhledem ke kr\u00e1tk\u00e9mu polo\u010dasu rozpadu jak\u00e1koli mezera sni\u017euje ochranu b\u011bhem kritick\u00e9ho obdob\u00ed vazospazmu.<\/p>\n<h3 class=\"wp-block-heading\">Pou\u017e\u00edv\u00e1 se nimodipin na migr\u00e9nu?<\/h3>\n<p>Nimodipin byl studov\u00e1n pro <strong>profylaxe migr\u00e9ny<\/strong> se sm\u00ed\u0161en\u00fdmi v\u00fdsledky. N\u011bkte\u0159\u00ed pacienti maj\u00ed prosp\u011bch, ale nejde o l\u00e9k prvn\u00ed volby pro prevenci migr\u00e9ny \u2014 propranolol, topiram\u00e1t a valpro\u00e1t maj\u00ed siln\u011bj\u0161\u00ed d\u016fkazy. Pou\u017e\u00edv\u00e1 se off-label, kdy\u017e jin\u00e9 mo\u017enosti selhaly nebo jsou kontraindikov\u00e1ny.<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017ee nimodipin sn\u00ed\u017eit krevn\u00ed tlak p\u0159\u00edli\u0161?<\/h3>\n<p>Ano \u2014 hypotenze je hlavn\u00edm klinick\u00fdm probl\u00e9mem. U pacient\u016f se SAH je udr\u017een\u00ed adekv\u00e1tn\u00edho mozkov\u00e9ho perfuzn\u00edho tlaku kl\u00ed\u010dov\u00e9. Krevn\u00ed tlak by m\u011bl b\u00fdt pravideln\u011b monitorov\u00e1n a d\u00e1vka m\u016f\u017ee b\u00fdt sn\u00ed\u017eena na polovinu (30 mg ka\u017ed\u00e9 4 hodiny) u pacient\u016f s jatern\u00edm po\u0161kozen\u00edm nebo v\u00fdraznou hypotenz\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Jak dlouho trv\u00e1 l\u00e9\u010dba?<\/h3>\n<p>Standardn\u00ed protokol je <strong>21 po sob\u011b jdouc\u00edch dn\u016f<\/strong>, bez ohledu na to, zda dojde k vazospazmu. Nejrizikov\u011bj\u0161\u00ed obdob\u00ed jsou dny 3\u201314, ale l\u00e9\u010dba pokra\u010duje a\u017e do 21. dne, aby pokryla pozdn\u00ed p\u0159\u00edpady vazospazmu.<\/p>\n<h3 class=\"wp-block-heading\">Je Nimodip stejn\u00fd jako Nimotop?<\/h3>\n<p>Oba obsahuj\u00ed nimodipin 30 mg. Nimotop je p\u016fvodn\u00ed zna\u010dka spole\u010dnosti Bayer. Nimodip je bioekvivalentn\u00ed generikum za ni\u017e\u0161\u00ed cenu.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;font-size:13px;\"><strong>Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje odbornou l\u00e9ka\u0159skou pomoc. P\u0159ed zah\u00e1jen\u00edm, zm\u011bnou nebo ukon\u010den\u00edm jak\u00e9hokoli l\u00e9ku se v\u017edy pora\u010fte s kvalifikovan\u00fdm zdravotnick\u00fdm pracovn\u00edkem. D\u00e1vkov\u00e1n\u00ed odpov\u00edd\u00e1 \u00fadaj\u016fm v\u00fdrobce a publikovan\u00fdm klinick\u00fdm doporu\u010den\u00edm \u2014 individu\u00e1ln\u00ed pot\u0159eby se mohou li\u0161it.<\/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\/glinil-m\/\">Glinil M<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/trinicalm-plus\/\">Objednejte si Glynase XL (5 mg nebo 10 mg (XL)) od spole\u010dnosti MedsBase v balen\u00edch po 30, 60, 90 nebo 180 tablet\u00e1ch. Dod\u00e1v\u00e1me po cel\u00e9m sv\u011bt\u011b, s diskr\u00e9tn\u00edm balen\u00edm a certifikovan\u00fdm v\u00fdrobcem WHO-GMP.<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/opiprol\/\">Opiprol<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/atrest\/\">Atrest<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ramgee\/\">Ramgee<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 L\u00e9\u010d\u00ed hypertenzi<br \/>\n\u2705 Prevence mrtvice<br \/>\n\u2705 Zlep\u0161uje pr\u016ftok krve<br \/>\n\u2705 Sni\u017euje frekvenci migr\u00e9n<br \/>\n\u2705 Zm\u00edr\u0148uje probl\u00e9my souvisej\u00edc\u00ed s mozkem<\/p>\n<p>Nimodip obsahuje Nimodipine.<\/p>","protected":false},"featured_media":59457,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3468],"product_tag":[3892,3893],"class_list":{"0":"post-59456","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-neurological-conditions-and-epilepsy","9":"product_tag-nimodip","10":"product_tag-nimodipine","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/59456","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=59456"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/59457"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=59456"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=59456"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=59456"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=59456"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}