The Pharmaceutical Journal
Vol 270 No 7234 p141
1 February 2003

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Nimodipine fails to show benefit in eclampsia trial

Magnesium sulphate is more effective than nimodipine (Nimotop) in preventing eclampsia in women with severe pre-eclampsia, researchers have found.

Dr Michael Belfort, of the University of Utah, Salt Lake City, and colleagues hypothesised that if eclampsia is caused by cerebral ischaemia, nimodipine would be an alternative therapy to magnesium sulphate with potential advantages (oral administration, minimal toxicity, and antihypertensive effect). However, their findings do not support this.

They randomised 1,650 women with severe pre-eclampsia to either oral nimodipine (60mg every four hours) or intravenous magnesium sulphate (given according to local protocol) until 24 hours post partum. They found that the women who received nimodipine were more likely to have a seizure than those who received magnesium sulphate (2.6 per cent vs 0.8 per cent, P=0.01).

The researchers conclude that the lack of effectiveness of nimodipine — a cerebral vasodilator — supports the hypothesis that eclampsia may be caused by cerebral overperfusion rather than decreased cerebral blood flow (New England Journal of Medicine 2003;348:304).