Nimodipine Reappraised: An Old Drug With a Future

Andrew    P.    Carlson; Daniel       Hänggi; Robert   L.   Macdonald; Claude   W.   Shuttleworth
doi:10.2174/1570159X17666190927113021
Abstract

Nimodipine is a dihydropyridine calcium channel antagonist that blocks the flux of extracellular calcium through L-type, voltage-gated calcium channels. While nimodipine is FDAapproved for the prevention and treatment of neurological deficits in patients with aneurysmal subarachnoid hemorrhage (aSAH), it affects myriad cell types throughout the body, and thus, likely has more complex mechanisms of action than simple inhibition of cerebral vasoconstriction. Newer understanding of the pathophysiology of delayed ischemic injury after a variety of acute neurologic injuries including aSAH, traumatic brain injury (TBI) and ischemic stroke, coupled with advances in the drug delivery method for nimodipine, have reignited interest in refining its potential therapeutic use. In this context, this review seeks to establish a firm understanding of current data on nimodipine’s role in the mechanisms of delayed injury in aSAH, TBI, and ischemic stroke, and assess the extensive clinical data evaluating its use in these conditions. In addition, we will review pivotal trials using locally administered, sustained release nimodipine and discuss why such an approach has evaded demonstration of efficacy, while seemingly having the potential to significantly improve clinical care.
Keywords: Delayed cerebral ischemia, vasospasm, subarachnoid hemorrhage, L-type calcium channel, nimodipine, sustained release delivery.
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DOI https://dx.doi.org/10.2174/1570159X17666190927113021	Print ISSN 1570-159X
Publisher Name Bentham Science Publisher	Online ISSN 1875-6190
Current Neuropharmacology

Nimodipine Reappraised: An Old Drug With a Future

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