Rufinamide and Nimodipine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Rufinamide
Nimodipine
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced nimodipine plasma concentrations and lack of nimodipine efficacy
Interaction Deep Dive
Concomitant use of rufinamide, a mild CYP3A4 inducer2, with nimodipine, a CYP3A4 substrate, may result in decreased nimodipine plasma levels and reduced antihypertensive efficacy of nimodipine. Patients receiving concomitant therapy should be monitored closely for lack of antihypertensive response to nimodipine, and increased nimodipine dosage may be necessary 1.
Why it happens (mechanism)
Induction of CYP3A4-mediated metabolism of nimodipine by rufinamide
Common questions
Can I take Rufinamide and Nimodipine together?
Reduced nimodipine plasma concentrations and lack of nimodipine efficacy Always confirm with your pharmacist or prescriber before making any change.
How serious is the Rufinamide and Nimodipine interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Rufinamide or Nimodipine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (2)
- Product Information: nimodipine oral capsules, nimodipine oral capsules. Caraco Pharmaceutical Laboratories, Ltd. (per DailyMed), Detroit, MI, 2012. DailyMed
- Product Information: BANZEL(R) film coated oral tablets, oral suspension, rufinamide film coated oral tablets, oral suspension. Eisai Co, Ltd, Woodcliff Lake, NJ, 2011.
Keep reading about Rufinamide
Keep reading about Nimodipine
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