DOSAGE & ADMINISTRATION
Migraine Prophylaxis:
Starting Dose: 10 mg at night in patients less than 65 years of age and 5 mg
daily in patients older than 65 years. If, during this treatment depressive,
extrapyramidal or other unacceptable symptoms occur, administration
should be discontinued. If, after 2 months of this initial treatment, no
significant improvement is observed, the patient should be considered a
non-responder and administration should be discontinued.
Maintenance Treatment: If a patient is responding satisfactorily and if a
maintenance treatment is needed, the dose should be decreased to 5 days
treatment at the same daily dose with two successive medicine free days
every week. Even if the prophylactic maintenance treatment is successful
and well tolerated, it should be interrupted after 6 months and it should be
re-initiated only if the patient relapses.
Peripheral Vascular disease: 10 mg twice daily, up to 30 mg per day if required.
Vertigo & motion sickness: 10-20 mg daily for adults and 5 mg daily for
children (> 40 kg).
Epileptic seizure: 15-20 mg daily in adults and 5 to 10 mg daily for children as
an add-on therapy.
CONTRAINDICATION
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.
WARNINGS & PRECAUTION
Flunarizine may lead to drowsiness which is aggravated by the simultaneous
intake of alcohol or other central nervous system depressants. Patients
should be cautioned against driving motor vehicles or performing other
potentially hazardous tasks where a loss of mental alertness may lead to
accidents. Flunarizine is not suited for aborting a migraine attack. The
possible occurrence of an attack is therefore no reason to increase the dose
of Flunarizine.This treatment may give rise to extrapyramidal and depressive
symptoms and reveal Parkinsonism, especially in predisposed patients such
as the elderly. Flunarizine should therefore be used with caution in such
patients.
SIDE EFFECTS
Drowsiness and/or fatigue, as well as weight gain and/or increased appetite
may occur.The following adverse experiences have been reported during
chronic treatment with Flunarizine: depression, of which female patients
with a history of depressive illness may be particularly at risk; extrapyramidal
symptoms (such as bradykinesia, rigidity, akathisia, orofacial dyskinesia,
tremor), of which elderly patients seem particularly at risk.Infrequently
reported adverse reaction are: heartburn; nausea; gastralgia; insomnia;
anxiety; galactorrhoea; dry mouth; muscle ache;skin rash.
DRUG INTERACTIONS
Galactorrhoea 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 may interact with
flunarizine by increasing its metabolism. So an increase in dosage of
flunarizine may be required.
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