Drug interactions
Cimetidine + Nimodipine
Severity: Moderate
Cimetidine and Nimodipine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cimetidine can raise nimodipine blood concentrations, increasing the risk of hypotension, flushing and headache. This matters particularly in patients with subarachnoid hemorrhage, where low blood pressure may compromise cerebral perfusion.
What this interaction means in plain words
Cimetidine and Nimodipine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cimetidine belongs to Gastrointestinal Tract; Nimodipine belongs to Cardiovascular.
Why it happens
Cimetidine inhibits CYP3A4-mediated hepatic and intestinal metabolism of nimodipine, which has high first-pass extraction.
What to do
Monitor blood pressure closely and consider splitting the nimodipine dose or lowering it if hypotension develops. Consider switching to an H2 blocker or PPI with little CYP inhibition.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
Other interactions of Nimodipine
- Apalutamide + Nimodipine Major
- Carbamazepine + Nimodipine Major
- Ceritinib + Nimodipine Major
- Clarithromycin + Nimodipine Major
- Cobicistat + Nimodipine Major
- Darunavir + Nimodipine Major
Frequently asked questions
Can I take Cimetidine with Nimodipine?
MediHelp rates the interaction as moderate. Cimetidine and Nimodipine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cimetidine can raise nimodipine blood concentrations, increasing the risk of hypotension, flushing and headache. This matters particularly in patients with subarachnoid hemorrhage, where low blood pressure may compromise cerebral perfusion.
How serious is the interaction between Cimetidine and Nimodipine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure closely and consider splitting the nimodipine dose or lowering it if hypotension develops. Consider switching to an H2 blocker or PPI with little CYP inhibition.
What other medicines interact with Cimetidine?
MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine page.
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