Last update: Oct. 9, 2016

Flunarizine Hydrochloride

High Risk for breastfeeding


Poorly safe. Evaluate carefully.
Use safer alternative or interrupt breastfeeding 3 to 7 T½.
Read the Comment.

Calcium-channel-blocking drug which is a piperazine derivative antihistamine with sedative effects.
Used in prophylaxis of migraines and dizziness.

At latest update no published data on excretion into breast milk were found.
It may increase prolactin level (from Cortelli Formisano 1985 to 1991).
Despite its high protein-binding capacity, because of a very long half-life span (18 days), there is a higher risk of excretion into breastmilk.

A known and safer alternative should be preferred until more published data on this drug related to breastfeeding is available, - e.g. Propranolol, Metoprolol, Sertraline, Escitalopram, Amitrptilina or Valproate for Migraine prophylaxis (Pringsheim 2012, Davanzo 2014) and Nimodipine, Betahistine or Ginkgo biloba for vertigo prophylaxis, especially in the neonatal period and in case of prematurity.

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Flunarizine Hydrochloride in other languages or writings:

Group

Flunarizine Hydrochloride belongs to this group or family:

Tradenames

Main tradenames from several countries containing Flunarizine Hydrochloride in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. > 80 %
Molecular weight 405 daltons
Protein Binding 99 %
VD 78 l/Kg
Tmax 2 - 4 hours
T1/2 432 hours

References

  1. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014 Abstract
  2. HPRA. Flunarizine. Drug Summary. 2014 Full text (in our servers)
  3. AEMPS. Flunarizina. Ficha técnica. 2013 Full text (in our servers)
  4. Pringsheim T, Davenport W, Mackie G, Worthington I, Aubé M, Christie SN, Gladstone J, Becker WJ; Canadian Headache Society Prophylactic Guidelines Development Group. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci. 2012 Abstract Full text (in our servers)
  5. Teive HA, Troiano AR, Germiniani FM, Werneck LC. Flunarizine and cinnarizine-induced parkinsonism: a historical and clinical analysis. Parkinsonism Relat Disord. 2004 Abstract
  6. Formisano R, Falaschi P, Cerbo R, Proietti A, Catarci T, D'Urso R, Roberti C, Aloise V, Chiarotti F, Agnoli A. Nimodipine in migraine: clinical efficacy and endocrinological effects. Eur J Clin Pharmacol. 1991 Abstract
  7. Bonuccelli U, Piccini P, Paoletti AM, Nuti A, Colzi A, Melis GB, Muratorio A. Flunarizine increases PRL secretion in normal and in migraineous women. J Neural Transm. 1988 Abstract
  8. Cortelli P, Santucci M, Righetti F, Pirazzoli P, Albani F, Baruzzi A, Sacquegna T, Cacciari E. Neuroendocrinological evidence of an anti-dopaminergic effect of flunarizine. Acta Neurol Scand. 1988 Abstract
  9. Maestri E, Manzoni GC, Marchesi G, Camellini L, Rossi G, Veneri G, Gnudi A. Effect of flunarizine on pituitary secretion by healthy men and in woman with migraine. Eur J Clin Pharmacol. 1987 Abstract
  10. Facchinetti F, Sances G, Bakalakis C, Morgillo MG, Lottici P, Cicoli C, Genazzani AR. Neuroendocrine effects of flunarizine treatment in postmenopausal women. Cephalalgia. 1985 Abstract
  11. Cortelli P, Santucci M, Righetti F, Pirazzoli P, Cacciari E, Albani F, Baldrati A, De Carolis P, Baruzzi A, Sacquegna T. Hormonal and metabolic changes induced by flunarizine therapy: preliminary results. Cephalalgia. 1985 Abstract
  12. Flor SC. Determination of the calcium antagonist flunarizine in biological fluids by gas-liquid chromatography. J Chromatogr. 1983 Abstract
  13. Woestenborghs R, Michielsen L, Lorreyne W, Heykants J. Sensitive gas chromatographic method for the determination of cinnarizine and flunarizine in biological samples. J Chromatogr. 1982 Abstract

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