Intravenous Nimotop Use Linked to Deaths, FDA Warns

At least four people have been killed after their healthcare providers attempted to administer the drug Nimotop intravenously, according to federal regulators.  

The FDA issued a drug safety communication warning on Tuesday, warning that Nimotrop capsules should only be given by mouth or feeding tube, and should never be administered intravenously. Despite a black box warning added in 2006, intravenous use of the drug after patients had trouble swallowing the liquid-filled capsules has resulted in four patient deaths and nearly killed five others.

Overall, the FDA has received 31 reports of medication error involving Nimotop, 25 of which were attempts at intravenous delivery. In most cases, the patient was hospitalized in a critical care unit and was already receiving intravenous medications.

Nimotop (nimodipine) is a calcium channel blocker used to treat neurologic complications caused by ruptured blood vessels in the brain. The Bayer drug was approved by FDA in 1988, but is sometimes prescribed off-label to treat high blood pressure.

The FDA first put a label warning on Nimotop regarding intravenous use in 1996. In 2006, FDA upgraded that to a black box warning, detailing the risks of intravenous injection. However, the FDA indicates that it has continued to receive a steady stream of reports of healthcare professionals attempting to give the drug intravenously.

The side effects of Nimotop intravenous injection include death, cardiac arrest, severe drops in blood pressure and other heart-related problems. It is never safe to give the drug intravenously, the FDA warns.

Doctors who have patients who are unable to swallow are advised to administer the drug by extracting the liquid from the capsule with a syringe, and then giving it to the patient through a nasogastric tube. The FDA recommends that the syringe be labeled “Not for IV Use.”