Q; Nimodipine has strong 'black box' warning against IV administration but still there are reports of IV administration of Nimodipine 'by error'. How?


Answer: Intravenous nimodipine can result in death, cardiac arrest, due to acute fall in blood pressure.

When PO administration is not feasible it is given via nasogastric tube. The recommended way is to make a hole in both ends of the capsule with an 18 gauge needle, and the contents of the capsule extracted into a syringe. This may be the reason of 'by error' administration of Nimodipine via IV route.

FDA advise that the syringe be labeled "Not for IV Use." The needle should be removed from the syringe and the contents should then be emptied into the patient's in situ nasogastric tube and washed down the tube with 30 mL of normal saline (0.9%).



Source: FDA (here)