Flunarizine

You have been given a medicine called flunarizine which has been used in medical practice for over 25 years. It belongs to a group of medicines known as calcium channel blockers which work by preventing the narrowing of blood vessels. If you have any questions after reading this leaflet, speak to your doctor or pharmacist.

Why have I been prescribed flunarizine?

• Flunarizine is used to prevent migraine when other medicines have been unsuccessful.
• This medication is unlicensed in the UK, although it is quite commonly used to prevent migraine-type headaches in many other European countries, where it is licensed.
• It may reduce the number of migraine attacks you suffer from and how severe they are.
• Flunarizine is taken on a regular daily basis to prevent attacks; it is not used to treat acute migraine attacks.
• It may take several weeks or months for treatment to take full effect.

Speak to your doctor before taking flunarizine if:

• You have a history of depression (there are likely to be safer treatment options if you are currently suffering with depression)
• You have a history of movement disorders, such as Parkinson’s disease
• You are intolerant of lactose
• You have liver damage
• You are pregnant/planning on becoming pregnant or breastfeeding.

How should I take flunarizine?

• Always follow your doctor’s instructions.
• Flunarizine is usually taken once a day, normally in the evening.
• Swallow whole with water
• The dose you are prescribed will vary but is normally 5mg or 10mg each day. Occasionally doses of up to 15mg a day may be prescribed.
• Flunarizine should be taken every day but your doctor may tell you to only take it on certain days (e.g. Monday to Friday). Your doctor will explain this to you.
• If you forget to take a dose, wait until your next dose is due then continue as normal.
• Treatment is normally continued for six to twelve months. Your doctor will advise you on the exact duration.

Can I take other medicines whilst I am taking flunarizine?

• Some medicines may affect how flunarizine works.
• Check with your doctor or pharmacist if you have any concerns or if you are taking any other medicines, including herbal medicines.

What are the side effects of flunarizine?

All medicines have possible side effects but not all patients experience them.

Common side effects of flunarizine (affecting more than one patient in every 100 treated) include:

• Increased appetite and weight gain. Weight gain is seen in about 1 in 10 patients. You should weigh yourself twice a week and stop the drug immediately if your weight is significantly increasing.
• Tiredness and drowsiness which may affect your ability to drive. This can be reduced by taking the dose at night, or by starting with a lower dose. It may also be reduced by avoiding alcohol. If drowsiness is persistent at the lowest dose of half a tablet daily then stop the medication and inform your doctor.
• Low mood or depression may occur in approximately 1 in 20 patients. If this happens you should stop the medicine straight away and speak to your doctor. Please be aware that depression can occur any time after starting treatment and may be a delayed side effect.
• Blocked or runny nose
• Feeling sick, stomach ache and constipation
• Muscle pains
• Breast pains
• Irregular periods

Uncommonly, flunarizine can cause jerky movements and problems such as slowness, muscle stiffness or rigidity and trembling. Twitching or unusual movements of the tongue, face, mouth, jaw or throat can occur. If this happens stop taking the medicine immediately and speak to your doctor as soon as possible. These symptoms usually disappear if flunarizine is stopped promptly.

Flunarizine is not formally licensed in the UK. It is licensed in other European countries and imported. It does not mean that the medicine is unsafe.

Occasionally doctors will prescribe unlicensed medicines if they feel that they are the best option for an individual patient. Flunarizine is usually only prescribed by a specialist and is always dispensed from the hospital’s pharmacy. Contact your consultant in writing 6 weeks before a new prescription is due with details of your current dose and the benefits seen. Your doctor will need to know specifically that you have not experienced significant weight gain, mood disturbance, abnormal movements or any other potential side effects before continuing flunarizine treatment.

Further information about migraines is available from the Migraine Trust website (www.migrainetrust.org).