Flunarizine
Indications
Flunarizine is used for:
Migraine, Vertigo, Peripheral vascular disease, Cerebrovascular disorders, Vestibular disorders
Adult Dose
Oral
Prophylaxis of migraine; Prophylaxis of vertigo and vestibular disorders; Prophylaxis of peripheral and cerebrovascular disorders
Adult:
The usual dose is 5 to 10 mg daily, usually given at night to minimize the effects of drowsiness.
For migraine prophylaxis: Starting dose is 10 mg daily (at night) for patients less than 65 years and 5 mg daily for patients older than 65 years.
Maintenance treatment: If a patient’s response is satisfactory and if a maintenance treatment is needed, the dose should be decreased to 5 days (of a week) treatment at the same daily dose and 2 successive drug free days.
Treatment should be interrupted after 6 months and re-initiated only if the patient relapses. The recommended maximum daily dose is 10 mg daily in adults.
For vertigo and motion sickness : The recommended maximum daily dose of Flunarizine in the treatment of vertigo is 10 mg daily in adults.
For peripheral vascular disorders: The recommended daily dose of Flunarizine in the treatment of peripheral vascular disorders is 5 to 10 mg in the evening.
For epilepsy: An optimal therapeutic dosage in epileptic patients receiving other anti-epileptic drugs is 15 to 20 mg daily in adults.
Child Dose
Oral
Prophylaxis of migraine; Prophylaxis of vertigo and vestibular disorders; Prophylaxis of peripheral and cerebrovascular disorders
Child:
The usual dose is 5 mg daily, usually given at night to minimize the effects of drowsiness.
Maintenance treatment: If a patient’s response is satisfactory and if a maintenance treatment is needed, the dose should be decreased to 5 days (of a week) treatment at the same daily dose and 2 successive drug free days. Treatment should be interrupted after 6 months and re-initiated only if the patient relapses. The recommended maximum daily dose is 5 mg daily in children (< 40 kg).
For vertigo and motion sickness : The recommended maximum daily dose of Flunarizine in the treatment of vertigo is 5 mg daily in children ( < 40 kg).
For epilepsy: An optimal therapeutic dosage in epileptic patients receiving other anti-epileptic drugs is 5 to 10 mg daily in children.
Renal Dose
Administration
May be taken with or without food.
Contra Indications
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.
Precautions
Flunarizine may lead to drowsiness which is aggravated by the simultaneous intake of alcohol or other central nervous system depressants. Patients should avoid driving motor vehicles or performing other potentially hazardous tasks where a loss of mental alertness may lead to accidents. Flunarizine should therefore be used with caution in such patients.
Pregnancy-Lactation
The safety of Flunarizine for use in pregnancy and lactation has not been established.
Interactions
Galactorrhea has been reported in few women on oral contraceptives within the first two months of Flunarizine treatment. Hepatic enzyme inducers such as carbamazepine and phenytoin increase the metabolism of Flunarizine. So an increase in dose of the drug may be required. Concomitant use of a calcium channel blocker and amiodarone has been reported to result in sinus arrest and atrioventricular block.
Adverse Effects
Side effects of Flunarizine :
Drowsiness. Rarely wt gain, headache, depression, gastric pain, dry mouth, insomnia, extrapyramidal reactions, galactorrhoea.
Mechanism of Action
Flunarizine has H1-receptor blocking action and calcium-channel blocking effect. It has also been used as an adjunct epileptic therapy for patients refractory to standard treatment regimens.