Nimodipine in subarachnoid hemorrhage

Nimodipine has recently been approved for the treatment of cerebral ischemia caused by subarachnoid hemorrhage. Chemically, nimodipine is in the same group of calcium channel blockers as nifedipine and nicardipine. It has greater lipid solubility and, thus, greater selectivity for cerebral blood vessels. Nimodipine has been shown in most studies to reduce the morbidity and mortality from cerebral ischemia following subarachnoid hemorrhage. However, recent clinical studies have cast some doubt on this benefit. At recommended doses, the drug is well tolerated and toxicity is low. However, other approaches to the treatment of cerebral ischemia from vasospasm should not be omitted when using nimodipine.