the package insert of the medicine Eugerial.
The remedy Eugerial be for the treatment of cerebral ischemia; disorders, ischemic in patients with subarachnoid hemorrhage post-rupture of aneurysms congenital; senile dementia; neurological deficits in memory, concentration and attention; dizziness; nausea; acúfenos.
When should I not use?
Recognized hypersensitivity to the active ingredient of the product, or to any of the excipients. Severe hepatic insufficiency (cirrhosis).
How to use?
The use of the remedy Eugerial, the dose will be adapted to the clinical picture and the evolution of each patient. As dosage guidance, we recommend: 1 tablet, two to three times per day, away from meals (at least 1 hour before or 2 hours after). In some cases (for example, subarachnoid hemorrhage caused by spontaneous rupture of cerebral aneurysms), you can use 2 tablets of 60 mg of nimodipine four to six times per day. The interval between shots should never be less than 4 hours. – Overdose: in cases of acute intoxication, one can expect severe drop in blood pressure, accompanied by tachycardia or bradycardia. If arising from oral intake, it is recommended immediate gastric lavage plus charcoal. For the treatment of hypotension, administer dopamine, norepinephrine, or substances simpaticomiméticas. Infusion of calcium gluconate would seem to be appropriate. There is no specific antidote. Elderly patients: it is recommended extreme caution in elderly patients with multiple organ failure: severe renal insufficiency (clearance < 20 ml/min) and severe heart failure.
What are the evils that can cause me?
In therapeutic doses, nimodipine is usually well tolerated. In some patients it may present slight drop in blood pressure. The international bibliography registers distinct adverse reactions in a low percentage of patients: headache, designed of skin, feeling of heat, sweating, drowsiness, nausea, vomiting, pruritus, retention hidrossalina, palpitations, hypertension, anemia, thrombocytopenia, hemorrhage, gastrointestinal, bruising, jaundice, hepatitis, difficulty breathing, confusion and increased vasospasm. With very high doses (90 mg or more every 4 hours) have been described in some cases of neurological deterioration, congestive heart failure, disseminated intravascular coagulation and deep vein thrombosis. It has been described in rare cases of increase in liver transaminases (SGPT, alkaline phosphatase, and LDH), decrease in the natremia and the increase of blood sugar levels in some.
Warnings and Precautions
what should I know before using?
nimodipine can cause drop in blood pressure in patients previously hypertensive or intensify the effects of drugs hipotensores. You should carefully monitor the blood pressure and the pulse rate in patients with liver function impaired, since metabolism of the drug may be decreased in such patients. In these patients, the initial dose of nimodipine should be reduced. As the toxicity of nimodipine during pregnancy has not yet been studied, should be very well considered the advantages and the risks of a possible administration during this condition. It is recommended extreme caution in elderly patients with multiple organ failure: severe renal insufficiency (clearance < 20 ml/min) and severe heart failure. Caution in use in patients with severe hypotension (SBP < 90 mmHg). – Drug interactions: in patients with high blood pressure, use of antihypertensive drugs, nimodipine may potentiate the effect of anti-hypertensive. The association with other calcium antagonists or alfametildopa should be avoided whenever possible. However, if you must resort to such association, one should keep the patient under strict surveillance. The administration associated with anticonvulsants (phenobarbital, phenytoin, carbamazepine) may increase the plasma concentration of nimodipine, not recommending this type of association. Renal function can deteriorate during concomitant treatment with drugs potentially nephrotoxic, and patients with this function is already compromised. Renal function should be carefully monitored in these cases, and treatment discontinuation should be considered. The concentration of nimodipine in your blood may increase when cimetidine or valproic acid are administered simultaneously. Appropriate information about the concurrent use with neuroleptics and antidepressants are not available.