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Action/Kinetics:
Has a greater effect on cerebral arteries than arteries elsewhere in the body (probably due to its highly lipophilic properties). Mechanism to reduce neurologic deficits following subarachnoid hemorrhage not known.
Peak plasma levels: 1 hr.
t
1/2: 1-2 hr. Significantly bound (over 95%) to plasma protein. Undergoes first-pass metabolism in the liver; metabolites excreted through the urine.
Uses:
Improvement of neurologic deficits due to spasm following subarachnoid hemorrhage from ruptured congenital intracranial aneurysms; clients should have Hunt and Hess grades of I-III.
Investigational: Migraine headaches and cluster headaches.
Contraindications:
Lactation.
Special Concerns:
Safety and efficacy have not been established in children. Use with caution in clients with impaired hepatic function and reduced hepatic blood flow. The half-life may be increased in geriatric clients.
Side Effects:
CV: Hypotension, peripheral edema, CHF, ECG abnormalities, tachycardia, bradycardia, palpitations, rebound vasospasm, hypertension, hematoma,
DIC, DVT.
GI: Nausea, dyspepsia, diarrhea, abdominal discomfort, cramps,
GI hemorrhage vomiting.
CNS: Headache, depression, lightheadedness, dizziness.
Hepatic: Abnormal LFT, hepatitis, jaundice.
Hematologic: Thrombocytopenia, anemia, purpura, ecchymosis.
Dermatologic: Rash, dermatitis, pruritus, urticaria.
Miscellaneous: Dyspnea, muscle pain or cramps, acne, itching, flushing, diaphoresis, wheezing, hyponatremia.
Laboratory Test Alterations:
Nonfasting BS, LDH, alkaline phosphatase, ALT.
Platelet count.
How Supplied:
Capsule: 30 mg
Dosage
?Capsules
Adults: 60 mg q 4 hr beginning within 96 hr after subarachnoid hemorrhage and continuing for 21 consecutive days. Reduce the dose to 30 mg q 4 hr in clients with hepatic impairment.
