Flunarizine
Indications
Long-term treatment for migraine headaches when other therapies are ineffective or poorly tolerated.
Dose.
5 mg (½ tablet) a day in the evening for 4 to 8 weeks.
If depression, extrapyramidal symptoms, or any other serious side effects develop, treatment should be discontinued.
If there is no response after 8 weeks, the patient will be considered unresponsive and treatment will be discontinued.
In case of insufficient clinical response, an increase in the dose to 10 mg (1 tablet) per day may be considered depending on tolerance. However, this increase will only be made in an adult under 65 years of age.
In children older than 12 years, exceptionally, a treatment with 1/2 tablet can be tried.
Do not exceed a treatment period of more than 6 months.
Contraindications.
Hypersensitivity to flunarizine or to any of the excipients.
Pre-existing symptoms of Parkinson's disease.
History of extrapyramidal symptoms.
Depressive illness or history of recurrent depressive syndrome.
Side effects.
Infections and infestations.
- Common: Rhinitis
Metabolism and nutrition disorders.
- Common increased appetite
Psychiatric disorders
- Common depression, insomnia
- Uncommon Depressive syndrome (see Warnings and precautions for use), sleep disturbances, apathy, anxiety.
Nervous system disorders
- Common drowsiness
- Uncommon Coordination abnormal, disorientation, lethargy, paraesthesia, impatience, slowness, tinnitus, neck stiffness Unknown acatisia, bradykinesia, dyskinesias, essential tremor, extrapyramidal syndrome, parkinsonism, sedation, tremor
Cardiac disorders
- Infrequent palpitations
Vascular disorders
- Uncommon hypotension
Gastrointestinal disorders
- Common Constipation, upset stomach, nausea
- Uncommon Intestinal obstruction, dry mouth, gastrointestinal disturbances
Hepatobiliary disorders
- Unknown Increased liver transaminases
Skin and subcutaneous tissue disorders
- Uncommon hyperhidrosis
- Unknown rash
Musculoskeletal and connective tissue disorders
- Common myalgia
- Uncommon muscle spasms, muscle spasms
- Unknown muscle stiffness
Reproductive system and breast disorders
- Frequent menstrual irregularities, breast pain
- Uncommon Menorrhagia, menstrual disturbances, oligomenorrhea, breast enlargement, decreased libido
- Unknown galactorrhea
General manifestations and anomalies in the administration site.
- Common fatigue
- Uncommon Peripheral edema, peripheral edema, asthenia
- Very frequent weight gain
Action mechanisms.
Flunarizine has H1 antihistamine, antidopaminergic and anticholinergic action.
Flunarizine is a selective calcium channel blocker. Its use in the basic treatment of migraine would also be based on the selective opposition to the entry of calcium ions into the cell.
Flunarizine has no effect on contractility or cardiac conduction.