From the Guidelines
Flunarizine is primarily used to prevent migraine headaches and treat vertigo, with a typical dose of 10 mg taken once daily, usually at bedtime, as supported by studies such as 1. The medication works by blocking calcium channels in the brain, which helps to reduce the frequency and severity of migraines. It also has antihistamine properties, which contribute to its effectiveness in treating vertigo and dizziness. Some key points to consider when using flunarizine include:
- The need for continued treatment should be reassessed after 3-6 months of use.
- Common side effects can include drowsiness, weight gain, and depression.
- Elderly patients may be more susceptible to these side effects and may require a lower starting dose of 5 mg daily.
- Flunarizine should not be abruptly discontinued; tapering off the medication under medical supervision is recommended.
- Patients with a history of depression or Parkinson's disease should use this medication with caution and under close medical supervision. It's also important to note that while flunarizine has proven efficacy in the prevention of migraine, other calcium-channel blockers such as nifedipine, nimodipine, cyclandelate, and verapamil have poor quality evidence and are difficult to interpret, suggesting only a modest effect, as seen in studies like 1. Overall, flunarizine is a viable option for the prevention of migraine headaches and treatment of vertigo, but its use should be carefully considered and monitored by a healthcare professional, as supported by the evidence from studies such as 1.
From the Research
Uses of Flunarizine
Flunarizine is a calcium channel blocker with various therapeutic applications, including:
- Prophylactic treatment for common or classic migraine in children and adults 2, 3
- Reducing the frequency of seizures in patients with partial or generalized epilepsy resistant to conventional antiepileptic drugs 2
- Treatment of vertigo and associated symptoms of either peripheral or central origin 2, 3, 4, 5
- Treatment of cerebrovascular insufficiency where psychological symptoms are the primary symptoms 2
- Prophylaxis of migrainous vertigo 4, 5
- Potential use as an atypical antipsychotic for the treatment of schizophrenia 6
Therapeutic Efficacy
Studies have shown that flunarizine is:
- At least as effective as other agents, such as pizotifen, cinnarizine, and nimodipine, in the prophylaxis of migraine 2, 3
- Effective in reducing the frequency and severity of vertiginous episodes in patients with migrainous vertigo 4, 5
- Comparable to haloperidol in the treatment of schizophrenia, with a possible atypical profile 6
Administration and Side Effects
Flunarizine can be administered once daily due to its long plasma half-life 3. Common side effects include drowsiness, weight gain, and somnolence 3, 5, 6.