Nimodipine

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Prevention or Management Avoid co-administration of potent ENT1, CNT3, or BCRP transporter inhibitors (e.g., ritonavir, eltrombopag, curcumin, cyclosporine, dilazep, nifedipine, nimodipine, cilostazol, sulindac, dipyridamole, or reserpine) during the 4 to 5 day cladribine treatment cycles.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Exaggerated hypotensive response is possible with concomitant use. Monitor vital signs frequently; supportive care and/or discontinuation may be required.

An exaggerated hypotensive response is possible with concomitant use of magnesium sulfate and dihydropyridine calcium channel blockers.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Strong CYP3A4 inhibitor that significantly increases nimodipine plasma concentration and blood pressure lowering effect. Concomitant administration should generally be avoided.

Moderate and weak CYP3A4 inhibitors include alprozalam, ameprenavir, amiodarone, aprepitant, atazanavir, cimetidine, cyclosporine, diltiazem, erythromycin, fluconazole, fluoxetine, isoniazid, oral contraceptives, quinuprestin/dalfopristin, valproic acid, and verapamil.

Moderate CYP3A4 inhibitor that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

Moderate and weak CYP3A4 inducers include, for example: amprenavir, aprepitant, armodafinil, bosentan, efavirnenz, etravirine, Echinacea, modafinil, nafcillin, pioglitazone, prednisone, rufinamide, and vemurafenib.

Moderate CYP3A4 inhibitor that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

Moderate and weak CYP3A4 inhibitors include alprozalam, ameprenavir, amiodarone, aprepitant, atazanavir, cimetidine, cyclosporine, diltiazem, erythromycin, fluconazole, fluoxetine, isoniazid, oral contraceptives, quinuprestin/dalfopristin, valproic acid, and verapamil.

Moderate CYP3A4 inhibitor that increases nimodipine plasma concentration. A study showed 50% increase in peak concentrations and 90% increase in area under curve. Blood pressure monitoring and dose reduction may be necessary.

Moderate CYP3A4 inhibitor that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

CYP3A4 inducers may alter the first pass or clearance of nimodipine, potentially decreasing nimodipine levels.

Moderate CYP3A4 inhibitor and calcium channel blocker that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

Moderate and weak CYP3A4 inhibitors include alprozalam, ameprenavir, amiodarone, aprepitant, atazanavir, cimetidine, cyclosporine, diltiazem, erythromycin, fluconazole, fluoxetine, isoniazid, oral contraceptives, quinuprestin/dalfopristin, valproic acid, and verapamil.

Moderate and weak CYP3A4 inhibitors include alprozalam, ameprenavir, amiodarone, aprepitant, atazanavir, cimetidine, cyclosporine, diltiazem, erythromycin, fluconazole, fluoxetine, isoniazid, oral contraceptives, quinuprestin/dalfopristin, valproic acid, and verapamil.

Moderate CYP3A4 inhibitor that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

Calcium channel blockers: Diltiazem, felodipine, nifedipine, nicardipine, nimodipine, verapamil, amlodipine, nisoldipine, isradipine ↑ Calcium channel blockers Use with caution.

Phenytoin when given with the combination of fosamprenavir and ritonavir may increase the concentration of amprenavir Calcium channel blockers Nifedipine, nimodipine, nisoldipine, verapamil Other Albendazole (decreases active metabolite), chlorpropamide, clozapine, cyclosporine, digoxin, disopyramide, folic acid, methadone, mexiletine, praziquantel, quetiapine 7.3 Hyperammonemia with Concomitant Use of Valproate Concomitant administration of phenytoin and valproate has been associated with an increased risk of valproate-associated hyperammonemia.

Inhibits CYP3A4 and increases nimodipine plasma concentration. Ingestion of grapefruit/grapefruit juice is not recommended while taking nimodipine.

Moderate CYP3A4 inhibitor that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

CYP3A4 inhibitors may alter the first pass or clearance of nimodipine, potentially increasing nimodipine levels.

Moderate and weak CYP3A4 inducers include, for example: amprenavir, aprepitant, armodafinil, bosentan, efavirnenz, etravirine, Echinacea, modafinil, nafcillin, pioglitazone, prednisone, rufinamide, and vemurafenib.

Moderate CYP3A4 inhibitor that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

Phenytoin when given with the combination of fosamprenavir and ritonavir may increase the concentration of amprenavir Calcium channel blockers Nifedipine, nimodipine, nisoldipine, verapamil Other Albendazole (decreases active metabolite), chlorpropamide, clozapine, cyclosporine, digoxin, disopyramide, folic acid, methadone, mexiletine, praziquantel, quetiapine 7.3 Hyperammonemia with Concomitant Use of Valproate Concomitant administration of phenytoin and valproate has been associated with an increased risk of valproate-associated hyperammonemia.

Phenytoin when given with the combination of fosamprenavir and ritonavir may increase the concentration of amprenavir Calcium channel blockers Nifedipine, nimodipine, nisoldipine, verapamil Other Albendazole (decreases active metabolite), chlorpropamide, clozapine, cyclosporine, digoxin, disopyramide, folic acid, methadone, mexiletine, praziquantel, quetiapine 7.3 Hyperammonemia with Concomitant Use of Valproate Concomitant administration of phenytoin and valproate has been associated with an increased risk of valproate-associated hyperammonemia.

Moderate CYP3A4 inhibitor that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

Moderate and weak CYP3A4 inducers include, for example: amprenavir, aprepitant, armodafinil, bosentan, efavirnenz, etravirine, Echinacea, modafinil, nafcillin, pioglitazone, prednisone, rufinamide, and vemurafenib.

Moderate CYP3A4 inhibitor that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

Moderate and weak CYP3A4 inducers include, for example: amprenavir, aprepitant, armodafinil, bosentan, efavirnenz, etravirine, Echinacea, modafinil, nafcillin, pioglitazone, prednisone, rufinamide, and vemurafenib.

Moderate CYP3A4 inhibitor and calcium channel blocker that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

Interactions with other dihydropyridine calcium channel blockers have not been reported, but these agents (including felodipine, nicardipine, and nimodipine ) are all dependent upon P450 IIIA4 for metabolism, so similar interactions with quinidine should be anticipated.

Interactions with other dihydropyridine calcium-channel blockers have not been reported, but these agents (including felodipine, nicardipine , and nimodipine ) are all dependent upon P450 IIIA4 for metabolism, so similar interactions with quinidine should be anticipated.