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flunarizine (Sibelium)
Tradename: Sibelium
Indications:
1) migraine prophylaxis, including children [2] (NOT for aborting migraine)
2) symptomatic treatment of vestibular vertigo
Contraindications:
1) depression
2) extrapyramidal disorders, including Parkinson's disease
3) hemiplegia alterans
Dosage: 5-10 mg PO QD
Capsules: 5 mg
Pharmacokinetics:
1) well-absorbed from GI tract
2) peak plasma levels in 2-4 hours; steady state in 5-6 weeks
3) protein binding 99%
4) hepatic metabolism; metabolites excreted in bile & feces
5) terminal 1/2 life is 18 days
Adverse effects:
1) drowsiness
2) fatigue
2) depression, especially females with a history of depression
3) extrapyramidal effects (especially elderly)
4) uncommon
-> nausea, heartburn, insomnia, galactorrhea, anxiety, xerostomia, myalgia, rash
Overdose:
1) sedation, agitation, tachycardia
2) charcoal, gastric lavage, supportive therapy; no antidote
Drug interactions:
1) galactorrhea in women taking oral contraceptives
2) sedatives & CNS depressants
3) carbamazepine & phenytoin may increase metabolism of flunarizine
Mechanism of action:
1) calcium channel antagonist
2) reduces excessive transmembrane Ca+2 fluxes
Interactions
drug interactions
drug adverse effects (more general classes)
General
calcium channel blocker (CCB)
Database Correlations
PUBCHEM correlations
References
- http://home.intekom.com/pharm/janssen/sibelium.html
- Prescriber's Letter 12(3): 2005
Drug Therapy for Children and Adolescents with Migraine Headaches
Detail-Document#: 210307
(subscription needed) http://www.prescribersletter.com