Flunarizine

Oral
Prophylaxis of migraine, Vertigo and vestibular disorders

May be taken with or without food.

History of depression, pre-existing symptoms of Parkinson’s disease, other extrapyramidal disorders.

Hepatic impairment. Elderly. Pregnancy and lactation.

Significant: Depression, increased serum prolactin, menstrual irregularities, extrapyramidal symptoms. Rarely,: progressive fatigue, galactorrhoea.
Gastrointestinal disorders: Nausea, vomiting, constipation, stomach pain.
Investigations: Weight gain.
Metabolism and nutrition disorders: Increased appetite.
Musculoskeletal and connective tissue disorders: Myalgia.
Nervous system disorders: Drowsiness, somnolence.
Psychiatric disorders: Insomnia.
Respiratory, thoracic and mediastinal disorders: Rhinitis.

This drug may cause somnolence, if affected, do not drive or operate machinery.

Monitor for extrapyramidal, depressive, and fatigue symptoms.

Symptoms: Sedation, asthenia, agitation, tachycardia. Management. May give activated charcoal if considered appropriate.

Increases sedative effect with hypnotics and tranquillisers. Decreased plasma concentration with phenytoin, carbamazepine.

Increases sedative effect with alcohol.

Description: Flunarizine is a difluorinated derivative of cinnarizine. It has selective calcium-channel blocking activity, sedative and antihistamine properties, and has no effect on heart contractility or conduction.
Pharmacokinetics:
Absorption: Well absorbed from the gastrointestinal tract. Time to peak plasma concentration: 2-4 hours.
Distribution: Volume of distribution: 43.2 L/kg. Plasma protein binding: >90%.
Metabolism: Extensively metabolised in the liver via N-oxidation and aromatic hydroxylation.
Excretion: Mainly via faeces (<6%); urine (minimal). Elimination half-life: Approx 18 hours.

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 941361, Flunarizine. https://pubchem.ncbi.nlm.nih.gov/compound/Flunarizine. Accessed Sept. 24, 2020.

Store between 15-30°C. Protect from light and moisture.

Antimigraine Preparations / Peripheral Vasodilators & Cerebral Activators

N07CA03 - flunarizine ; Belongs to the class of antivertigo preparations.

Anon. Flunarizine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/08/2020.

Buckingham R (ed). Flunarizine Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/08/2020.

Flumig (Unison). MIMS Philippines. http://www.mims.com/philippines. Accessed 05/08/2020.

Sibelium (Johnson & Johnson Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my/. Accessed 05/08/2020.