Flunarizine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Migraine prophylaxis; Vertigo and vestibular disorders 10 mg daily in the evening.
Dosage Details
Oral
Prophylaxis of migraine, Vertigo and vestibular disorders
Adult: 10 mg daily in the evening.
Elderly: ≥65 years 5 mg daily in the evening.
Administration
May be taken with or without food.
Contraindications
History of depression, pre-existing symptoms of Parkinson’s disease, other extrapyramidal disorders.
Special Precautions
Hepatic impairment. Elderly. Pregnancy and lactation.
Adverse Reactions
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.
Patient Counseling Information
This drug may cause somnolence, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor for extrapyramidal, depressive, and fatigue symptoms.
Overdosage
Symptoms: Sedation, asthenia, agitation, tachycardia. Management. May give activated charcoal if considered appropriate.
Drug Interactions
Increases sedative effect with hypnotics and tranquillisers. Decreased plasma concentration with phenytoin, carbamazepine.
Food Interaction
Increases sedative effect with alcohol.
Action
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.
Chemical Structure

Chemical Structure Image
Flunarizine_01

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.

Storage
Store between 15-30°C. Protect from light and moisture.
ATC Classification
N07CA03 - flunarizine ; Belongs to the class of antivertigo preparations.
References
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.

Disclaimer: This information is independently developed by MIMS based on Flunarizine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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