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Medication Errors Involving Administration of Nimodipine
by admin on: April 8th, 2011

The U.S. Food and Drug Administration (FDA) posted a safety announcement on their website after receiving reports that the drug, Nimodipine, is being improperly administered to patients. According to the reports filed with the FDA, the adverse consequences (death, cardiac arrest, severe drops in blood pressure, and other heart-related complications) resulting from this misuse are often serious and sometimes fatal.

Nimodipine is a drug that is classified as a calcium channel blocker. Nimodipine is indicated for reducing the occurrence and severity of ischemic deficits in patients who present with a subarachnoid hemorrhage that occurs when a patient is in a critical care setting. A subarachnoid hemorrhage is a bleeding that occurs in the subarachnoid space, which is an area between the brain and the thin tissues that covers the brain. Subarachnoid hemorrhages may occur following a rupture of a blood vessel in the brain.

Nimodipine is prepared as a capsule, and should only be administered through a feeding tube (nasogastric tube), or by mouth. These adverse consequence reports the FDA have been receiving have indicated that the method of administration used in these cases was intravenous. This safety announcement is the most recent action taken by the FDA regarding the wrongful intravenous use of nimodipine. In 1996, the FDA required a bolded statement regarding the proper (and improper) method for administrating this drug be added to the prescribing information for nimodipine. In 2006, the FDA added additional warnings to both the box for nimodipine, and the drug label on the nimodipine container. After review of the reports submitted to the FDA, the two most common factors that lead to the misuse of this drug are:

  1. Some patients have difficulty swallowing the nimodipine capsule. While instructions for extracting the medication are included, the use of a syringe for extracting the medication increases the likelihood that this medicine will be administered intravenously.
  2. Most patients receiving this drug are already prepared to receive intravenous medications.

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