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March 18, 2020

Flunarizine is a medication used to prevent migraine attacks with or without aura. It is widely prescribed in continental Europe for the prevention of migraine. This medicine can significantly reduce migraine frequency, attacks and severity in both adults and children. It is also used to treat and prevent vertigo of central and peripheral origin, occlusive peripheral vascular disease and other conditions of the inner ear and the brain.

It belongs to the group of selective calcium antagonist drugs with moderate other actions including serotonin receptor, antihistamine, and dopamine blocking activity. Its mechanism of action is not well understood but it is believed that this drug works by blocking the influx of extracellular calcium inside the cells by physically plugging the channel. This inhibits the contractile process of smooth muscle cells causing the systemic and coronary arteries to dilate. As a result, there is an increase in oxygen supply in the myocardial tissue, decreasing the peripheral resistance and blood pressure. It is also believed to block the neurotransmitter causing the blood vessels to relax.

Compare with other calcium channel blockers, this drug has a low affinity to voltage-dependent calcium channels. It’s well absorbed in the gut and may reach its peak concentration after two to four hours. However, the effect of this drug is cumulative and may take weeks to show. The time this medicine remains effective in the body is based on its use and form of administration. 

When and How to Use Flunarizine

Take Flunarizine exactly as directed. The initial dose in treating migraine prophylaxis is 10mg a day for those who are below 65 years of age. Patients who are 65 years of age and above must take 5 mg only a day. Discontinue using if you will experience unacceptable adverse reactions. The maintenance dose should be decreased to only 5 days a week. It may take 6 to 8 weeks of continued treatment before you can fully notice the maximum effect of this medicine. If there is no significant improvement after 2 months of treatment, discontinue the medication.

Take your medications by mouth exactly as prescribe by your doctor. Take it at around the same time each day. If you happen to miss a dose, take it as soon as you remember. If it is almost time for you to take the dose, skip it and resume with your usual dosing. Do not take two medicines just to make up for the missed one. Use this continuously to prevent migraine attacks from occurring. 

What to know before taking Flunarizine

  • This drug is contraindicated in patients with an acute phase of stroke, depression, Parkinson’s disease, and extrapyramidal symptoms. Do not use this in patients who are hypersensitive to its ingredients.
  • Patients who have hypotension, arrhythmia or heart failure should not use this drug. Inform your doctor first before using this drug so your doctor may discuss the risk and benefits associated with the use of this medicine.
  • It is not suitable for pregnant women unless deemed necessary by your doctor. Breastfeeding women must not also use this unless absolutely necessary. It is advisable for breastfeeding mother to discontinue taking Flunarizine.
  • Use this with caution in patients with:
    • Female patients with a history of depressive illness
    • Elderly patients
    • Pregnant or breastfeeding women unless absolutely necessary
    • Liver or kidney disease
    • History of depression
    • Movement disorder
  • Flunarizine is not recommended for:
    • Children below 18 years of age
    • Parkinson’s disease
    • Patients who are allergic to Flunarizine or any other components present in it
    • Patients who suffer from depression or any other depressive disorders
    • Patients with partial or total bowel obstruction, partial or total obstruction of the urinary tract
    • If you have a genetic disorder of the blood and skin or porphyria

Possible Side Effects of Flunarizine

Flunarizine may cause unwanted side effects aside from its intended effects. Common side effects are:

  • Nausea
  • Drowsiness
  • Weight gain
  • Anxiety
  • Ringing in the ear
  • Increased appetite
  • Excessive/ no sleep
  • Change in libido
  • Runny nose
  • Dry mouth

If symptoms persist inform your doctor. Inform also your doctor if you experience any of the following symptoms:

  • Irregular heartbeat
  • Muscle ache
  • Difficulty breathing
  • Depression
  • Irregular menstrual cycle
  • Swelling of the face, lips, tongue, eyelid, hand or feet
  • Skin rash
  • Elevated liver enzymes
  • Excessive sweating
  • Tremor

Getting the Best Result from Flunarizine

  • Limit your alcohol intake while using this medicine. Refrain from operating heavy machinery or from driving while using this drug.
  • Do not use this to treat an on-going migraine attack.
  • Limit your alcohol intake as this can cause excessive drowsiness and sleepiness when under medication. Refrain from driving and operating heavy machinery while using this medication.
  • Pregnant or breastfeeding women must only use this when clearly needed.
  • Inform your doctor if you are taking other medications including over-the-counter or prescription medication, vitamins, and mineral supplements.
  • The use of this medicine may cause sleep disturbances, low mood and lack of interest in some patients. Use this with caution in patients with active or past depression.

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