Medicine Information

Migon

Name: Migon
Brand: Migon
Rating: 4.5 (117 reviews)

Tablet5 mgCalcium Channel BlockersATC: N07CA03

Generic Name

Flunarizine

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
migon 5 mg tablet	৳ 3.00	৳ 42.00

Description

Overview of the medicine

Migon 5 mg Tablet contains Flunarizine, a selective calcium entry blocker primarily used for the prophylaxis of migraine. It helps to reduce the frequency and severity of migraine attacks by stabilizing vascular smooth muscle cells and preventing cellular calcium overload. It is also used in the symptomatic treatment of vertigo.

Uses & Indications

Prophylaxis of migraine (to reduce frequency and severity of attacks)

Symptomatic treatment of vertigo and dizziness (of central and peripheral origin)

Adjunctive therapy in cerebrovascular disorders (e.g., in elderly patients with symptoms of cerebral ischemia)

Dosage

Adults

Migraine prophylaxis: Initially 5 mg once daily at bedtime for 4-8 weeks. If no significant improvement, discontinue treatment. If improvement is sustained, continue for 6 months, then stop therapy to reassess. May restart if relapse occurs. Vertigo: 5 mg once daily at bedtime until symptoms are controlled, usually for up to 2 months.

Elderly

Migraine prophylaxis: Initially 5 mg once daily at bedtime for 4-8 weeks. Vertigo: Same as adults, but caution is advised due to increased risk of side effects, particularly extrapyramidal symptoms and depression.

Renal_impairment

No specific dose adjustment is generally required, but caution is advised and patients should be monitored for adverse effects due to potential for accumulation.

How to Take

Take orally, usually once daily at bedtime. Tablets should be swallowed whole with water, not crushed or chewed. Can be taken with or without food.

Mechanism of Action

Flunarizine selectively blocks calcium entry into cells, particularly in vascular smooth muscle and cerebral tissue, thereby preventing cellular calcium overload. It also has antihistaminic, sedative, and anti-dopaminergic properties. It stabilizes neuronal membranes and inhibits vasoconstriction caused by vasoactive substances, contributing to its antimigraine effect. For vertigo, it reduces the excitability of the vestibular system.

Pharmacokinetics

Onset

Therapeutic effects for migraine prophylaxis may take several weeks (typically 4-8 weeks) of consistent use to become apparent. Immediate effect for vertigo is observed but full control takes time.

Excretion

Primarily excreted via feces (approximately 60%) in the form of metabolites and unchanged drug, with a smaller portion (less than 5%) excreted in urine.

Half life

Approximately 18-23 days (terminal elimination half-life) in most individuals, leading to accumulation with regular dosing.

Absorption

Well absorbed (over 80%) from the gastrointestinal tract, reaching peak plasma concentrations (Cmax) within 2-4 hours after oral administration.

Metabolism

Extensively metabolized in the liver, primarily via the CYP2D6 and CYP2C9 enzymes. Its main metabolite is hydroxy-flunarizine.

Side Effects

Contraindications

Hypersensitivity to flunarizine or any other component of the formulation.
Patients with a history of depressive illness or pre-existing symptoms of Parkinson's disease or other extrapyramidal disorders.
Acute porphyria.

Drug Interactions

Oral contraceptives

No significant interaction reported, but theoretical consideration for enzyme induction exists.

Antiepileptic drugs (e.g., phenytoin, carbamazepine, valproate)

May alter flunarizine plasma concentrations; monitoring is recommended.

CNS depressants (e.g., alcohol, hypnotics, sedatives, anxiolytics)

May enhance sedative effects; caution is advised.

Storage

Store in a cool, dry place below 30°C. Protect from light and moisture. Keep all medicines out of the reach of children.

Overdose

Symptoms of overdose include sedation, bradycardia, tachycardia, and respiratory depression. Management is symptomatic and supportive. Gastric lavage may be considered within one hour of ingestion. There is no specific antidote for flunarizine overdose.

Pregnancy & Lactation

Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Flunarizine is excreted in breast milk in animal studies; therefore, it is not recommended during breastfeeding unless clearly necessary.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets (1x10 blister)30 tablets (3x10 blisters)

Shelf Life

Typically 2-3 years from the manufacturing date, depending on the manufacturer and specific formulation.

Availability

Pharmacies, Hospitals

Approval Status

Approved in many countries including Bangladesh

Patent Status

Generic available, original patent expired

Clinical Trials

Flunarizine has undergone extensive clinical trials demonstrating its efficacy in reducing the frequency and severity of migraine attacks. Studies have also supported its use in the symptomatic treatment of vertigo. Ongoing research continues to explore its potential in other neurological conditions and optimize treatment protocols.

Lab Monitoring

Monitor liver function tests periodically, especially during long-term therapy.
Regularly monitor body weight.

Doctor Notes

For migraine prophylaxis, consider a 'drug holiday' after 6-8 months of continuous effective treatment to reassess the necessity of continued therapy and mitigate long-term adverse effects.
Carefully screen patients for a history of depression or Parkinson's disease before initiating flunarizine. Monitor closely for the emergence or worsening of depressive symptoms and extrapyramidal signs during treatment.
Counsel patients regarding potential weight gain and drowsiness, especially at the start of therapy.

Patient Guidelines

Take the medication consistently at bedtime as prescribed by your doctor.
Be aware that drowsiness may occur, especially at the start of treatment. Avoid driving or operating heavy machinery until you know how the medication affects you.
Report any mood changes, persistent fatigue, or unusual movements (e.g., tremor, stiffness) to your doctor immediately.
It may take several weeks to notice the full prophylactic effect for migraine. Do not stop taking the medication abruptly without consulting your doctor.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

Flunarizine can cause drowsiness, fatigue, and impaired coordination. Patients should be advised not to drive or operate machinery until they have determined that the medication does not adversely affect their ability to perform such tasks safely.

Lifestyle Advice

Maintain a regular sleep schedule and ensure adequate rest.
Identify and avoid known migraine triggers (e.g., certain foods, stress, specific smells).
Incorporate regular, moderate exercise into your routine.