This article is from "Nankai Sun Pharmacist", which is used for medical science popularization for reference. Flunarizine is an anti-vertigo drug, which is a selective calcium channel blocker, which is obtained by structural modification of cinnarizine, and a fluorine atom is introduced into its chemical structure to enhance its lipid solubility, which is easy to penetrate the blood-brain barrier, and selectively inhibits calcium ions from entering cerebral vascular smooth muscle cells, preventing intracellular calcium overload, improving brain microcirculation and neuronal metabolism, and inhibiting cerebral vasospasm. In addition, flunarizine also has a vestibular inhibitory effect, can increase cochlear arteriole blood flow, improve vestibular organ circulation, and exert anti-vertigo effect, mainly suitable for the prevention of migraine with or without aura ** and the symptomatic ** caused by vestibular dysfunction**.
Of course, there are some off-label drugs in clinical practice, such as flunarizine can relax blood vessels, suitable for cerebrovascular disease, hypertension, bronchial asthma, irritable bowel syndrome, chronic renal failure, idiopathic tinnitus, etc., flunarizine has antihistamine effect, suitable for senile itching and chronic urticaria and other allergic diseases, flunarizine can block pathological calcium overload of nerve cells, prevent central nervous depolarization and abnormal discharge, prevent seizures, suitable for the auxiliary of epilepsy**, However, the efficacy and safety of these off-label drugs are not supported by reliable clinical trials, and they should be used with caution according to medical advice.
Flunarizine is common for drowsiness, drowsiness, fatigue, etc., and long-term use can also cause akathisia, tardive dyskinesia, depression and other serious ***, especially for the elderly, so it should be started in a small dose, and it is best to take it before bedtime to avoid falling injuries, and the drug should be stopped in time if it is serious.
For patients with vertigo, the method of taking flunarizine is: the starting dose for children under 65 years old is 10mg days (2 capsules), the starting dose for those over 65 years old is 5mg days (1 pill), taken before bedtime, the course of treatment is generally not more than 2 months, for patients with chronic vertigo, if the symptoms do not improve after 1 month of medication, it means that the drug response is not good, and the drug can be stopped, for patients with sudden vertigo, if the symptoms do not improve after 2 months of medication, the drug can be stopped, and the medication can be strictly followed by the doctor's instructions. Do not arbitrarily increase the dose or prolong the dose.
For migraine patients, the method of taking flunarizine is: the starting dose for children under 65 years old is 10mg days (2 capsules), and the starting dose for those over 65 years old is 5mg days (1 pill), take it before going to bed, maintain ** after the symptoms are controlled**, maintain ** for 5 consecutive days, stop taking the drug for 2 days, and maintain it for 6 months before stopping the drug, just in case**, if the symptoms do not improve significantly after 2 months of medication, it means that the response to the drug is not good, you can stop the drug, strictly follow the doctor's instructions, do not increase the dose or prolong the medication time at will.
Flunarizine has a good safety and tolerability profile, and common *** include:
Gastrointestinal tract: gastrointestinal reactions such as nausea, vomiting, stomach pain, and loss of appetite are common, and a small number of patients may have diarrhea and constipation, and increased appetite and weight gain have been reported.
Central nervous system: As mentioned above, flunarizine is the most common drowsiness, drowsiness, exhaustion, fatigue, etc., ***A small number of patients can experience dizziness, headache, insomnia, irritability, lack of concentration, etc. Long-term medication can see depression, suicidal tendencies and other serious *** women are more common, and can also cause Parkinson's syndrome, akathisia, facial tremor, oral molexico, acute torticollis and other extrapyramidal reactions, usually appear after 3 weeks of medication, generally stop the drug for 2 weeks to 6 months to recover.
Gingival hyperplasia: gingival hyperplasia is gingival overgrowth, which occurs as early as 1 month after starting the drug and at the latest after 2 years of medication, and most cases report that the patients are over 50 years old and can fully recover after stopping the drug.
Eyes: Blurred vision.
What is the difference between flunarizine and nimodipine in preventing migraines?
Nimodipine is also a calcium channel blocker, which also has strong fat solubility, easy to penetrate the blood-brain barrier, and has a similar mechanism of action to flunarizine, selectively acting on cerebral vascular smooth muscle, dilating cerebral arteries, increasing cerebral blood flow, protecting neuronal cells, and reducing ischemic brain injury caused by vasospasm, which is mainly suitable for the prevention and treatment of cerebral vasospasm after subarachnoid hemorrhage and the improvement of blood circulation during the recovery period of acute cerebrovascular disease.
For migraine, flunarizine has definite efficacy, clear indications, can effectively reduce the degree of headache, significantly reduce the frequency of migraine attacks, is the best drug recommended by the "Chinese migraine prevention and treatment guidelines", and nimodipine has no indication for migraine prevention, safety and efficacy have not been verified, the dosage and course of treatment are not clear, and clinical studies have shown that the efficacy of nimodipine in the prevention and treatment of migraine is not better than that of placebo, and it is not recommended for the prevention and treatment of migraine.
*Which is more effective for migraine, diclofenac sodium or flunarizine?
Diclofenac sodium is a migraine acute stage ** drug, belongs to the strong non-steroidal analgesic anti-inflammatory drugs, mainly by inhibiting cyclooxygenase, interfering with the synthesis of inflammatory and pain-causing substances prostaglandins, exerting anti-inflammatory and analgesic effects, can quickly and continuously relieve headaches, prevent headache recurrence, and enable patients to return to normal life as soon as possible, diclofenac sodium capsules have a faster onset of effect, and the efficacy is better than tablets, the recommended dose is 50-100mg per day, and continuous medication should not exceed 1 week. Flunarizine capsules are mainly used for the prevention of migraine, which can reduce the frequency of headache attacks, shorten the duration of headaches, reduce the degree of headache attacks, and improve the effect of acute stages.