cinnarizine and Vascular-Diseases

Flunarizine is a 'selective' calcium entry blocker with a similar chemical structure and pharmacological profile to the related compound, cinnarizine. However, in contrast to cinnarizine it has a long plasma half-life and need only be given once a day. The majority of therapeutic trials in the prophylaxis of migraine, occlusive peripheral vascular disease and vertigo of central or peripheral origin have been placebo-controlled, and have shown that the drug produces significantly greater beneficial effects than placebo as evaluated by subjective and objective criteria. A small number of comparative studies have shown flunarizine to be at least as effective as pizotifen in migraine prophylaxis, and in a longer term study as effective as cinnarizine in vertigo of central origin. However, it has not been compared with other drugs which may be useful in these areas, such as methysergide in migraine prophylaxis, some antihistamines or phenothiazines in vertigo, or (understandably at this stage of its evolution) with surgical revascularisation in severe occlusive peripheral vascular disease. In preliminary placebo-controlled studies there was some evidence that flunarizine may improve impaired cognitive function in patients with cerebrovascular disorders, but such findings need further confirmation in additional carefully conducted studies. With a very long half-life, flunarizine may be given once daily; and drowsiness, the main side effect, can be minimised by taking the daily dose in the evening. Thus, it appears that flunarizine will offer a useful alternative in some therapeutic areas that can be difficult to manage with previously available therapy. However, a definitive statement on its relative place in therapy of such conditions must await a few well-controlled comparative studies.

Topics: Adult; Age Factors; Aged; Animals; Anti-Arrhythmia Agents; Anticonvulsants; Blood; Calcium Channel Blockers; Cinnarizine; Clinical Trials as Topic; Flunarizine; Histamine H1 Antagonists; Humans; Kinetics; Migraine Disorders; Piperazines; Vascular Diseases; Vasodilator Agents; Vertigo

Flunarizine is a 'selective' calcium entry blocker with a similar chemical structure and pharmacological profile to the related compound, cinnarizine. However, in contrast to cinnarizine it has a long plasma half-life and need only be given once a day. The majority of therapeutic trials in the prophylaxis of migraine, occlusive peripheral vascular disease and vertigo of central or peripheral origin have been placebo-controlled, and have shown that the drug produces significantly greater beneficial effects than placebo as evaluated by subjective and objective criteria. A small number of comparative studies have shown flunarizine to be at least as effective as pizotifen in migraine prophylaxis, and in a longer term study as effective as cinnarizine in vertigo of central origin. However, it has not been compared with other drugs which may be useful in these areas, such as methysergide in migraine prophylaxis, some antihistamines or phenothiazines in vertigo, or (understandably at this stage of its evolution) with surgical revascularisation in severe occlusive peripheral vascular disease. In preliminary placebo-controlled studies there was some evidence that flunarizine may improve impaired cognitive function in patients with cerebrovascular disorders, but such findings need further confirmation in additional carefully conducted studies. With a very long half-life, flunarizine may be given once daily; and drowsiness, the main side effect, can be minimised by taking the daily dose in the evening. Thus, it appears that flunarizine will offer a useful alternative in some therapeutic areas that can be difficult to manage with previously available therapy. However, a definitive statement on its relative place in therapy of such conditions must await a few well-controlled comparative studies.

Topics: Adult; Age Factors; Aged; Animals; Anti-Arrhythmia Agents; Anticonvulsants; Blood; Calcium Channel Blockers; Cinnarizine; Clinical Trials as Topic; Flunarizine; Histamine H1 Antagonists; Humans; Kinetics; Migraine Disorders; Piperazines; Vascular Diseases; Vasodilator Agents; Vertigo

Topics: Arteriosclerosis; Calcium; Cerebrovascular Disorders; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Humans; Intermittent Claudication; Leg Ulcer; Paresthesia; Piperazines; Vascular Diseases; Vasodilator Agents; Venous Insufficiency

The antivertiginous properties of flunarizine were evaluated in three consecutive studies --- two open and one double-blind --- in an total of 99 patients showing definite vertigo. Dosage was two tablets (= 20 mg) t.i.d. for three days in Study I (50 patients), 20 mg. t.i.d. for two months in study II (31 patients), and weekly decreasing doses of four, three, two and one (maintenance) tablets of flunarizine or placebo for three months in study III (9/18 patients with vertigo of recent origin). Improvement of vertigo was significant both objectively and subjectively in studies I and II. In study III, objective tests were always clearly in favour of flunarizine, but subjectively, flunarizine was superior only by month two. Vertigo of vascular origin seemed to be a preferential indication for flunarizine treatment. No major side-effects were found in these studies.

Topics: Adolescent; Adult; Aged; Cinnarizine; Electronystagmography; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Piperazines; Vascular Diseases; Vertigo; Vestibular Function Tests

Forty-one patients (21 males and 20 females) suffering from arterial hypertension associated with peripheral and cerebral vascular distress were treated for a period of 60 days with an extempore combination of labetalol (an antihypertensive drug with an alpha- and beta-blocking action) and flunarizine (a calcium-antagonist). Changes in supine and standing arterial blood pressure and in supine heart rate were evaluated periodically. Haematological and urinary controls of a number of biomedical indices were performed in basal conditions and after 60 days. The combination was found to show a rapid efficacy in the entire patient group: both supine and standing systolic and diastolic blood were significantly reduced as early as the tenth day of treatment. No significant changes in heart rate were observed. The combination revealed neither orthostatic hypotensive effects nor side-effects of such a degree of severity as to require reduction of the dose or discontinuation of the treatment.

Topics: Adrenergic alpha-Antagonists; Adrenergic beta-Antagonists; Adult; Aged; Blood Pressure; Calcium Channel Blockers; Cinnarizine; Drug Therapy, Combination; Ethanolamines; Female; Flunarizine; Heart Rate; Humans; Hypertension; Labetalol; Male; Middle Aged; Piperazines; Vascular Diseases

Topics: Cinnarizine; Flunarizine; Humans; Piperazines; Vascular Diseases

Topics: Arterial Occlusive Diseases; Arteriosclerosis; Biological Transport; Blood Viscosity; Calcium; Cell Membrane Permeability; Cinnarizine; Humans; Intermittent Claudication; Muscle, Smooth; Papaverine; Vascular Diseases

Topics: Blood Viscosity; Cerebral Infarction; Cinnarizine; Erythrocyte Membrane; Fibrinogen; Humans; Intermittent Claudication; Myocardial Infarction; Physical Exertion; Vascular Diseases