Regularly assess neurological status using a standardized scale like the Glasgow Coma Scale. Monitor for improvement in neurological deficits, such as decreased headache intensity and improved consciousness. Serial neuroimaging (CT or MRI) helps visualize vasospasm resolution.
Adverse Effects Monitoring
Closely monitor blood pressure, as hypotension is a common side effect. Watch for any signs of hepatic dysfunction (jaundice, abnormal liver function tests). Observe for gastrointestinal distress (nausea, vomiting, constipation). Report any edema, especially peripheral edema. Regularly check for dizziness, lightheadedness, or fainting.
Drug Interactions
Nimodipine’s metabolism is affected by CYP3A4 inhibitors (e. g., ketoconazole, erythromycin, grapefruit juice). Concomitant use may increase nimodipine levels, necessitating dose adjustment or close monitoring. Conversely, CYP3A4 inducers (e. g., rifampin, St. John’s wort) can decrease nimodipine levels, potentially reducing efficacy. Inform patients about potential interactions with other medications and supplements.
Specific Recommendations
Patients should be instructed to report any unusual symptoms immediately. Regular blood pressure monitoring is crucial, particularly during initial treatment. Liver function tests should be conducted before therapy and periodically thereafter. Consider using a standardized reporting form for consistent documentation of clinical findings and adverse events.
