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Flunarizine is a selective calcium antagonist, which is widely used in the prevention of migraine, and the treatment of dizziness, cerebral insufficiency and other diseases[1,2]. How to use flunarizine correctly? Let’s follow Jie Xiaoyao and have a look~
Pharmacological effects
Flunarizine can prevent cell damage caused by pathological calcium overload in cells caused by ischemia and other reasons. It can relieve the vasospasm of the basilar artery and the internal carotid artery; it can increase the blood flow of the cochlear arterioles and improve the circulation of the vestibular organs; it has an anti-epileptic effect, which can block the pathological calcium overload of nerve cells and prevent paroxysmal depolarization. Discharge to avoid seizures; improve renal function; have antihistamine effects [1,2].
Indications and Dosage
The indications, usage and dosage of flunarizine are shown in Table 1[1,2].
Table 1 Indications and dosage of flunarizine
Drug Interactions
1. On the basis of the application of antiepileptic drugs, the addition of flunarizine can improve the antiepileptic effect [4].
2. Flunarizine combined with betahistine can improve cerebral blood circulation, increase blood supply and oxygen supply to brain cells and inner ear, improve clinical symptoms of acute vertigo, and treat vertigo and vascular headache. and tinnitus can increase the efficacy [5,6].
3. When combined with alcohol, hypnotics or sedatives, the sedative effect is aggravated [2].
4. When combined with phenytoin and carbamazepine, the plasma concentration of flunarizine can be reduced [2].
Adverse reactions
The most common adverse reactions were drowsiness and/or fatigue (20%) and weight gain (11%). Depression and Parkinsonism are occasionally seen [2,7-8].
4 conditions disabled
1. Acute cerebral hemorrhage.
2. A history of depression, Parkinson’s disease or other extrapyramidal symptoms.
3. Allergic to flunarizine or any excipients of this product.
4. Since this drug can pass through the placental barrier and can be secreted with milk, although there are no reports of teratogenicity and effects on embryonic development, in principle, pregnant and lactating women do not use it This drug [2].
You should also pay attention to these 7 points when taking medicine
1. Not for the treatment of acute migraine.
2. After 1 month of treatment for chronic vertigo or 2 months of sudden vertigo, there is no improvement in symptoms, and the drug should be discontinued.
3. For the prevention of migraine, if there is no obvious improvement after 2 months of treatment, the drug should be stopped. Even if the curative effect is significant, the drug should be stopped for observation after 6 months of treatment, and the drug should be restarted only when it relapses.
4. During the medication process, the dosage should be strictly controlled. If depression or extrapyramidal reactions occur, the dosage should be reduced or discontinued in time.
5. Due to the sensitive nervous system and weak metabolic capacity of elderly patients, the dosage should be reduced as appropriate.
6. Use with caution in patients with hepatic insufficiency.
7. There may be adverse reactions of drowsiness after taking the drug, so drivers and machines should be used with caution; it is recommended to take this product before going to bed at night [2].
References:
[1] Xu Yunhong. Advances in clinical application of flunarizine hydrochloride [J]. China Medical Innovation, 2010, 7(12): 191-192.
[2] Flunarizine hydrochloride package insert.
[3] Ren Zhanxiu, He Qiu. Efficacy and safety of flunarizine hydrochloride in the preventive treatment of vestibular migraine [J]. Journal of Aeronautics and Astronautics, 2021, 32( 11): 1350-1352.
[4] Wang Shiwei. The clinical effect of flunarizine in the treatment of refractory epilepsy in children and its effect on the expression of multidrug resistance gene (MDR1)-mRNA[J]. Chinese Medicine Economics, 2019, 14(8): 52-54.
[5] Cai Meimei, Xie Anping. Clinical effect of flunarizine hydrochloride capsules combined with betahistine mesylate tablets in the treatment of benign vertigo[J]. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine, 2022, 32(6): 106-109.
[6] Luo Ni. Analysis of clinical application of betahistine mesylate combined with flunarizine hydrochloride in the treatment of tinnitus[J]. Chinese prescriptionMedicine, 2018, 16(3): 90-91.
[7] Xu Shuang, Xu Wei, Zhang Wei, et al. Safety analysis of flunarizine capsules [J]. Heilongjiang Medicine, 2021, 34(4): 820-822.
[8] Shi Jia. Research progress of drug-induced Parkinson’s syndrome caused by flunarizine [J]. Electronic Journal of Cardiovascular Diseases of Integrated Traditional Chinese and Western Medicine, 2016, 4( 35): 16.
Source: Medicine
Proofreading: Zang Hengjia
Editor in charge: Song Kunlun
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