Flunapen
Generic Name
Flunarizine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| flunapen 50 mg capsule | ৳ 8.02 | ৳ 80.20 |
| flunapen 150 mg capsule | ৳ 22.07 | ৳ 220.70 |
Description
Overview of the medicine
Flunapen (Flunarizine) is a selective calcium channel blocker indicated for the prophylaxis of migraine, and for the symptomatic treatment of vertigo and dizziness of vestibular origin. It helps prevent vasoconstriction and improves microcirculation.
Uses & Indications
Dosage
Adults
For migraine prophylaxis: Initially 5 mg daily at bedtime. If no improvement after 2 months, the dose can be increased to 10 mg daily at bedtime. If no significant improvement after 4 months, discontinue treatment. For vertigo: 5-10 mg daily at bedtime.
Elderly
Start with a lower dose (e.g., 2.5 mg or 5 mg daily at bedtime) and increase cautiously, monitoring for adverse effects.
Renal_impairment
No specific dose adjustment is generally required, but caution is advised in severe impairment due to potential accumulation of metabolites.
How to Take
Take orally, preferably at bedtime, with a glass of water, to minimize daytime drowsiness.
Mechanism of Action
Flunarizine selectively blocks the entry of calcium ions into vascular smooth muscle cells and erythrocytes, particularly in the cerebral vasculature. This action stabilizes vascular tone, prevents vasospasm, and improves blood flow. It also exhibits antihistaminic and sedative properties.
Pharmacokinetics
Onset
Clinical effects for migraine prophylaxis may take several weeks (e.g., 6-8 weeks) of continuous treatment to become apparent.
Excretion
Primarily excreted via faeces (about 60%) and urine (about 40%) as metabolites.
Half life
Approximately 18-23 days.
Absorption
Well absorbed from the gastrointestinal tract, with peak plasma concentrations reached within 2-4 hours.
Metabolism
Extensively metabolized in the liver via N-dealkylation by CYP enzymes, primarily CYP2D6.
Side Effects
Contraindications
- Known hypersensitivity to flunarizine or any component of the formulation
- Depressive illness or history of recurrent depressive episodes
- Parkinson's disease or other extrapyramidal disorders
Drug Interactions
Alcohol
May enhance sedative effects and impair cognitive function.
Antiepileptics (e.g., Carbamazepine, Phenytoin)
May reduce flunarizine plasma levels through enzyme induction, potentially reducing its efficacy.
CNS Depressants (e.g., sedatives, hypnotics, tranquilizers)
Concomitant use may potentiate sedative effects and increase the risk of drowsiness.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include sedation, bradycardia, tachycardia. Management is symptomatic and supportive, including gastric lavage and activated charcoal if overdose is recent.
Pregnancy & Lactation
Use during pregnancy is not recommended unless clearly necessary and the potential benefits outweigh the possible risks. Avoid during lactation as flunarizine may be excreted in breast milk and potentially cause adverse effects in the infant.
Side Effects
Contraindications
- Known hypersensitivity to flunarizine or any component of the formulation
- Depressive illness or history of recurrent depressive episodes
- Parkinson's disease or other extrapyramidal disorders
Drug Interactions
Alcohol
May enhance sedative effects and impair cognitive function.
Antiepileptics (e.g., Carbamazepine, Phenytoin)
May reduce flunarizine plasma levels through enzyme induction, potentially reducing its efficacy.
CNS Depressants (e.g., sedatives, hypnotics, tranquilizers)
Concomitant use may potentiate sedative effects and increase the risk of drowsiness.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include sedation, bradycardia, tachycardia. Management is symptomatic and supportive, including gastric lavage and activated charcoal if overdose is recent.
Pregnancy & Lactation
Use during pregnancy is not recommended unless clearly necessary and the potential benefits outweigh the possible risks. Avoid during lactation as flunarizine may be excreted in breast milk and potentially cause adverse effects in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Off-patent
Clinical Trials
Clinical trials have demonstrated flunarizine's efficacy in reducing the frequency and severity of migraine attacks and in managing vertigo symptoms. Studies have also focused on its safety profile and optimal dosing strategies.
Lab Monitoring
- Regular clinical monitoring for symptoms of depression and extrapyramidal disorders, especially during long-term therapy.
Doctor Notes
- Emphasize taking Flunapen at night to minimize daytime sedation.
- Monitor patients for signs of depression, anxiety, and extrapyramidal symptoms throughout treatment.
- Advise patients about potential weight gain and increased appetite.
- Flunapen is not suitable for acute migraine treatment.
Patient Guidelines
- Take the medicine at bedtime to reduce the impact of drowsiness during the day.
- Do not stop taking the medicine abruptly, as this may lead to withdrawal symptoms or a return of symptoms.
- Report any mood changes, unusual movements, or significant weight gain to your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it's almost time for your next dose. In that case, skip the missed dose and continue your regular dosing schedule. Do not double the dose to compensate.
Driving Precautions
Flunapen may cause drowsiness, especially at the beginning of treatment. Avoid driving or operating heavy machinery until you know how this medicine affects your ability to perform such tasks safely.
Lifestyle Advice
- Avoid alcohol consumption while on this medication, as it may increase drowsiness.
- Maintain a healthy diet and regular exercise to manage potential weight gain.
- Practice stress management techniques.
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