Nicaraven for the treatment of cerebral vasospasm in subarachnoid haemorrhage

Abstract

Cerebral vasospasm is a complication of subarachnoid haemorrhage and can cause cerebral ischaemia. Antivasospastic agents are used to relieve vasospasm after subarachnoid haemorrhage. A large number of agents with varying modes of action currently being investigated are reviewed. Pharmacology and clinical trials of nicaraven are discussed. The drug has been found to have both antivasospastic as well as neuroprotective effects. Clinically, the most documented efficacy of nicaraven is in the management of vasospasm associated with subarachnoid haemorrhage based on its free radical scavenging effect. Other potential areas for application are cerebral oedema associated with intracerebral haemorrhage and for neuroprotection in cerebral infarction. Nicaraven is in pre-registration by Chugai Pharma Ltd. in Japan for the treeatment of vasospasm following subarachnoid haemorrhage. The regulatory atmosphere in Japan regarding the approval of neuroprotectives is reviewed and nicaraven is likely to be approved by the year 2001 when the patent on it expires.

• AVS
• cerebral haemorrhage
• cerebral infarction
• cerebral oedema
• cerebrovascular disease
• free radical scavengers
• hydroxyl radical
• lipoxygenase inhibitor
• neuroprotection
• nicaraven
• oxidoreductase inhibitor
• stroke
• subarachnoid haemorrhage
• vasodilator
• vasospasm