Neumig
Generic Name
Flunarizine
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| neumig 25 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Neumig 25 mg Tablet contains Flunarizine, a calcium channel blocker primarily used for the prophylaxis of classical (with aura) or common (without aura) migraine, and for the symptomatic treatment of vertigo and dizziness associated with vestibular disorders.
Uses & Indications
Dosage
Adults
For migraine prophylaxis: Initially 5 mg once daily at bedtime for patients under 65 years. If response is inadequate, increase to 10 mg at bedtime. For vertigo: 10 mg once daily at bedtime. (Note: Neumig 25mg is a higher dose, typically not initial for all indications. Always follow specific physician prescription).
Elderly
For patients over 65 years, start with 5 mg once daily at bedtime. Monitoring for adverse effects is crucial.
Renal_impairment
No specific dose adjustment is generally required in renal impairment, but caution is advised. Consult a physician.
How to Take
Take orally with water, usually once daily at bedtime. It can be taken with or without food.
Mechanism of Action
Flunarizine selectively blocks calcium influx into vascular smooth muscle cells and erythrocyte membranes, preventing calcium overload. It also has some antihistaminic and sedative properties. It reduces the frequency and severity of migraine attacks by stabilizing cell membranes and reducing vascular reactivity.
Pharmacokinetics
Onset
Antimigraine effects may not be fully evident for several weeks (typically 4-8 weeks) of consistent use.
Excretion
Mainly excreted in the feces via biliary excretion; minor amounts are excreted in urine.
Half life
Elimination half-life is very long, ranging from 18 to 23 days (terminal half-life), leading to accumulation upon repeated dosing.
Absorption
Well absorbed from the gastrointestinal tract (about 80%), with peak plasma concentrations occurring 2-4 hours after oral administration.
Metabolism
Extensively metabolized in the liver, primarily via CYP2D6, forming several inactive metabolites.
Side Effects
Contraindications
- Known hypersensitivity to Flunarizine or any components of the formulation
- Depressive illness or a history of recurrent depressive episodes
- Parkinson's disease or other extrapyramidal disorders
- Acute cerebral hemorrhage or acute stroke (use with caution).
Drug Interactions
CNS depressants
Concurrent use with alcohol, hypnotics, sedatives, or tranquillizers may increase sedation.
Phenytoin, Carbamazepine, Valproate
May decrease Flunarizine plasma concentrations due to enzyme induction.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include sedation, bradycardia, tachycardia, hypotension, and agitation. Treatment is symptomatic and supportive; gastric lavage may be performed within one hour of ingestion.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Flunarizine is excreted in human milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Known hypersensitivity to Flunarizine or any components of the formulation
- Depressive illness or a history of recurrent depressive episodes
- Parkinson's disease or other extrapyramidal disorders
- Acute cerebral hemorrhage or acute stroke (use with caution).
Drug Interactions
CNS depressants
Concurrent use with alcohol, hypnotics, sedatives, or tranquillizers may increase sedation.
Phenytoin, Carbamazepine, Valproate
May decrease Flunarizine plasma concentrations due to enzyme induction.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include sedation, bradycardia, tachycardia, hypotension, and agitation. Treatment is symptomatic and supportive; gastric lavage may be performed within one hour of ingestion.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Flunarizine is excreted in human milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months
Availability
Pharmacies nationwide in Bangladesh
Approval Status
Approved by DGDA
Patent Status
Generic
Clinical Trials
Extensively studied in clinical trials for migraine prophylaxis and vertigo treatment, demonstrating efficacy and safety in various populations. Research continues on its long-term effects and optimal patient selection.
Lab Monitoring
- Liver function tests (periodically, especially with long-term use)
- Monitor for weight changes and depressive symptoms.
Doctor Notes
- Initiate treatment with the lowest effective dose and carefully titrate upwards if necessary, always considering the risk-benefit profile.
- Monitor patients for signs of depression, extrapyramidal symptoms, and significant weight changes, especially during long-term therapy or in elderly patients.
- Gradual withdrawal is recommended to avoid rebound symptoms and ensure patient comfort.
- Regularly reassess the need for continued treatment, particularly for migraine prophylaxis.
Patient Guidelines
- Take the medicine at bedtime to minimize daytime drowsiness.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Report any signs of depression or unusual movements (like tremors, difficulty walking) to your doctor.
- Avoid alcohol while on this medication.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not double the dose.
Driving Precautions
This medicine may cause drowsiness, especially at the start of treatment. Patients should be warned not to drive or operate machinery until they have determined how Flunarizine affects them.
Lifestyle Advice
- Maintain a regular sleep schedule.
- Practice stress-reduction techniques.
- Identify and avoid migraine triggers (e.g., certain foods, stress, lack of sleep).
- Regular physical activity may help manage migraines.
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Global Brand Names
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