What is the use of Flunarizine (a calcium channel blocker)?

From the Guidelines

Flunarizine is primarily used for the prevention of migraine headaches at a dose of 10 mg/d, due to its proven efficacy in reducing the frequency of migraine attacks. The use of Flunarizine, a calcium channel blocker, has been studied in the context of migraine prevention, and the evidence suggests that it is effective in reducing the frequency of migraine attacks 1.

Key Points

• The typical dose of Flunarizine for migraine prevention is 10 mg/d, as stated in the study 1.
• Flunarizine has been shown to have a modest effect in preventing migraine headaches, with adverse events including sedation, weight gain, and abdominal pain 1.
• It is commonly used in countries where it is available, and its efficacy has been demonstrated in several studies 1.

Considerations

• Patients with a history of depression or extrapyramidal symptoms, particularly elderly persons, should be cautious when using Flunarizine, as it may exacerbate these conditions 1.
• The medication should be initiated with a low dose and titrated slowly to minimize adverse events, and each treatment should be given an adequate trial of 2 to 3 months to assess its effectiveness 1.

Clinical Use

• Flunarizine is not widely available in the United States, but it is commonly used in Europe, Canada, and other countries for the prevention of migraine headaches 1.
• The medication works by blocking calcium channels in cerebral blood vessels, which helps prevent the vasospasm associated with migraines and improves cerebral blood flow 1.

From the Research

Uses of Flunarizine

• Flunarizine is a calcium channel blocker used in the prophylaxis of migraine, occlusive peripheral vascular disease, and vertigo of central or peripheral origin 2
• It has been shown to be effective in reducing the frequency of migraine attacks, with a monthly difference of 0.55 attacks (CI 95%= 0.215 0.895; p= 0.002) 3
• Flunarizine is also used in the treatment of migrainous vertigo, with a significant difference in the frequency of vertiginous episodes and improvement in severity of vertigo compared to non-specific vestibular treatment 4

Therapeutic Areas

• Migraine prophylaxis: flunarizine has been shown to be effective in reducing the frequency of migraine attacks, with a pooled analysis estimating a reduction of 0.4 attacks per 4 weeks compared with placebo 5
• Occlusive peripheral vascular disease: flunarizine has been used in the treatment of this condition, although its effectiveness compared to other treatments is not well established 2
• Vertigo of central or peripheral origin: flunarizine has been shown to be effective in reducing the frequency and severity of vertiginous episodes in patients with migrainous vertigo 4

Dosage and Side Effects

• The most common dose of flunarizine used is 10 mg per day, with doses up to 15 mg generally well tolerated 6
• Common side effects of flunarizine include somnolence, weight gain, and tiredness, with only 10.5% of patients stopping treatment due to adverse effects 6