Blood pressure and heart rate during treatment with nimodipine in patients with subarachnoid hemorrhage.

Careful observation of blood pressure and heart rate in patients with subarachnoid hemorrhage during therapy with nimodipine showed that blood pressure decreases mainly in hypertensive patients during the first hours of therapy or when treatment is started immediately with 2 mg per hour instead of the recommended initial dose of 1 mg per hour. Predominantly mild or moderate reversible falls in blood pressure were reported as side effects in 21/421 patients (5%). Electrocardiographic abnormalities such as tachycardia, bradycardia, arrhythmia or extrasystoles were reported as side effects during treatment with nimodipine in 18 patients (4,3%). Since the association of ECG abnormalities with subarachnoid hemorrhage has been known for many years it is likely that these abnormalities are not typical side effects of nimodipine but belong to the natural course of the disease.