Generic

Flunarizine

Indications

• Flunarizine is used to prevent migraine headaches, whether they are classic (with aura) or common (without aura).
• Treatment for vestibular vertigo symptoms (due to a diagnosed functional disorder of the vestibular system).
• Peripheral Vascular Disease (PVD) is a type of peripheral vascular disease (PVD)
• Suffering from motion sickness
• Conventional antiepileptic medication is ineffective in treating refractory epilepsy.

Pharmacology

The difluorinated derivative of cinnarizine is flunarizine. It is a calcium channel antagonist that is selective. Calcium transmembrane inflow is reduced by lowering excessive calcium transmembrane influx. Flunarizine prevents calcium excess in cells. It has no effect on normal calcium homeostasis in cells. Flunarizine also possesses calming and antihistaminic effects. It binds to plasma protein with a 99 percent affinity.

Dosage & Administration

Migraine Prophylaxis:

• Starting Dose: 10 mg at night in patients less than 65 years of age and 5 mg daily in patients older than 65 years. If, during this treatment depressive, extrapyramidal or other unacceptable symptoms occur, administration should be discontinued. If, after 2 months of this initial treatment, no significant improvement is observed, the patient should be considered a non-responder and administration should be discontinued.
• Maintenance Treatment: If a patient is responding satisfactorily and if a maintenance treatment is needed, the dose should be decreased to 5 days treatment at the same daily dose with two successive medicine free days every week. Even if the prophylactic maintenance treatment is successful and well tolerated, it should be interrupted after 6 months and it should be re-initiated only if the patient relapses.

Peripheral Vascular disease: 10 mg twice daily, up to 30 mg per day if required.

Vertigo & motion sickness: 10-20 mg daily for adults and 5 mg daily for children (> 40 kg).

Epileptic seizure: 15-20 mg daily in adults and 5 to 10 mg daily for children as an add-on therapy

Interaction

Galactorrhoea has been recorded in a small number of women taking oral contraceptives during the first two months of treatment with Flunarizine. Carbamazepine and phenytoin, both hepatic enzyme inducers, may interact with flunarizine by increasing its metabolism. As a result, an increase in flunarizine dosage may be necessary.

Contraindications

Hypersensitivity to Flunarizine. Flunarizine is contra-indicated in patients with a history of depressive illness, or with pre-existing symptoms of Parkinson’s disease or other extrapyramidal disorders.

Side Effects

Weight gain and/or increased hunger may occur, as well as drowsiness and/or exhaustion. During long-term Flunarizine use, the following side effects have been reported: Extrapyramidal symptoms (such as bradykinesia, rigidity, akathisia, orofacial dyskinesia, tremor), of which older patients appear to be more at risk; depression, of which female patients with a history of depressive disease may be particularly at risk. Heartburn, nausea, gastralgia, sleeplessness, anxiety, galactorrhoea, dry mouth, muscle discomfort, and skin rash are some of the less commonly reported side effects.

Pregnancy & Lactation

Safety in pregnancy and lactation has not been established.

Precautions & Warnings

Flunarizine may cause sleepiness, which is exacerbated if alcohol or other central nervous system depressants are consumed at the same time. Patients should be warned against driving or undertaking other potentially dangerous jobs when a loss of mental attention could result in an accident. Flunarizine isn’t recommended for stopping a migraine. The possibility of an attack is consequently no cause to raise Flunarizine dosage. This medication may cause extrapyramidal and depressive symptoms, as well as disclose Parkinsonism, particularly in people who are prone to it, such as the elderly. In such patients, flunarizine should be taken with caution.

Therapeutic Class

Miscellaneous prophylactic migraine preparations

Storage Conditions

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Pharmaceutical Name

Opsonin Pharma Ltd.