Drug Interaction Report

Telithromycin and Nimodipine: Interaction Details

A pharmacist-reviewed analysis of the Telithromycin and Nimodipine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Telithromycin

No brand names on record
+

Nimodipine

Nimotop Nimotop® Nymalize Nymalize®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Contraindicated
These should generally not be used together.
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.

Of 146 documented Telithromycin interactions, 13 are rated contraindicated — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Contraindicated

What happens

Increased serum nimodipine concentrations

Interaction Deep Dive

The concomitant use of nimodipine, a CYP3A4 substrate, with telithromycin, a strong CYP3A4 inhibitor2, is contraindicated as this may result in significantly increased plasma concentrations of nimodipine and significant hypotension 1.

Why it happens (mechanism)

Inhibition of CYP3A4-mediated nimodipine metabolism by telithromycin

Common questions

Can I take Telithromycin and Nimodipine together?

Increased serum nimodipine concentrations Always confirm with your pharmacist or prescriber before making any change.

How serious is the Telithromycin and Nimodipine interaction?

It is rated contraindicated. These should generally not be used together.

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 Telithromycin 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 a safer alternative to one of these medications for me?

References (2)

  1. Product Information: nimodipine oral capsules, nimodipine oral capsules. Caraco Pharmaceutical Laboratories, Ltd. (per DailyMed), Detroit, MI, 2012. DailyMed
  2. Product Information: KETEK(R) oral tablets, telithromycin oral tablets. Sanofi-Aventis, US, LLC, Bridgewater, NJ, 2010. DailyMed
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Telithromycin

Keep reading about Telithromycin

All Telithromycin interactions (146)
Also serious with: Lovastatin Simvastatin Alfuzosin Dihydroergotamine Injection
Nimodipine

Keep reading about Nimodipine

All Nimodipine interactions (77) Nimodipine drug information
Also serious with: Boceprevir Conivaptan Clarithromycin Voriconazole
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Telithromycin + Activated Charcoal American Hellebore Arsenic Cesium Ephedra Grapefruit Sida Cordifolia St. John's Wort + 170 more
Nimodipine + Activated Charcoal American Hellebore American Mistletoe Grapefruit St. John's Wort Tyramine Acacia Rigidula Adrafinil + 219 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.