Nimodipine Grapefruit juice

Fuhr, U., Maier-Bruggemann, A., Blume, H., Muck, W., Unger, S., Kuhlmann, J., Huschka, C., Zaigler, M., Rietbrock, S., and Staib, A.H., Grapefruit juice increases oral nimodipine bioavailability, Int. J. Clin. Pharmacol. Ther., 36, 126, 1998. 

Fuhr U, Maier-Bruggemann A, Blume H, et al. Grapefruit juice increases oral nimodipine bioavailability. Int J Clin Pharmacol Ther 1998 36(3) 126-132. 

Mean cerebrospinal fluid concentrations were estimated to be 0.3 0.2 (ig/ L in patients whose mean plasma concentrations were 76.9 34 (ig/ L [8], This indicates that nimodipine does not apparently bind to the cerebrospinal fluid proteins. The bioavailability of dihydropyridines following oral administration was found to increase after food intake, such as grapefruit juice [9]. After intravenous administration, nimodipine is distributed rapidly and uniformly. On the other hand, after oral administration, nimodipine is strongly differentiated, with high concentrations being found in the liver, kidneys, and fat, low concentrations in the brain and testes, and the rest in the plasma [10, 11]. Only small amounts of nimodipine pass through the placenta [11]. 

CALCIUM CHANNEL BLOCKERS GRAPEFRUIT JUICE t bioavailability of felodipine and nisoldipine (with reports of adverse effects), and t bioavailability of isradipine, lacidipine, lercanidipine, nicardipine, nifedipine, nimodipine and verapamil (without reported adverse clinical effects) Postulated that flavonoids in grapefruit juice (and possibly Seville oranges and limes) inhibit intestinal (but not hepatic) CYP3A4. They also inhibit intestinal P-gp, which may t the bioavailability of verapamil Avoid concurrent use of felodipine and nisoldipine and grapefruit juice... 

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