Cinnarizine and flunarizine

General information

Cinnarizine and flunarizine are piperazine derivatives with antihistaminic properties and calcium channel blocking activity [ ]. Flunarizine is the difluoro derivative of cinnarizine. Cinnarizine is used to treat motion sickness.

A few controlled clinical trials of flunarizine in patients with intermittent claudication have suggested significant improvements in subjective signs and some objective measurements. Its effectiveness in patients with cerebrovascular insufficiency has not been clearly shown, but its use in the prevention of migraine and other forms of common headache has been studied extensively. Several double-blind controlled studies have suggested that flunarizine in a dosage not over 10 mg/day reduces the frequency of headaches [ ]. Clinical studies of the antiepileptic efficacy of flunarizine have been equivocal [ ].

With a maintenance dosage of 10 mg/day, the main adverse effects of flunarizine are somnolence, sedation, fatigue, and drowsiness during the first few days in up to 10% of patients. During prolonged treatment some patients note difficulty in sleeping, lethargy, and reduced motivation. A dosage of 20 mg/day or more can cause drowsiness, increased sweating, peripheral edema, and fatigue [ ].

Organs and systems