Non-selective calcium channel blocker (migraine prophylaxis) · Migraine prophylaxis (calcium channel blocker), Calcium channel blocker (migraine prophylaxis), Migraine prophylaxis (migraine prophylaxis (calcium channel blocker))
KDIGO 2024 + manufacturer label
Selective calcium-overload blocker with antihistaminic and dopamine-D2 activity; reduces neuronal calcium influx and vascular reactivity, used for migraine prophylaxis and vertigo.
Avoid unless clearly necessary (limited data).
Limited data; caution.
Increased incidence and severity of parkinsonism, tremor, akathisia, and tardive dyskinesia.
Avoid concomitant use, especially in elderly patients or those with pre-existing neurological conditions. If unavoidable, monitor closely for EPS and consider dose reduction of either drug.
Increased sedation, drowsiness, impaired psychomotor function
Advise patients to avoid or limit alcohol consumption while on flunarizine.
Increased sedation, drowsiness, dizziness, dry mouth, and constipation.
Use with caution. Monitor for excessive sedation and anticholinergic effects. Advise patients about impaired ability to perform hazardous tasks.
Increased sedation, drowsiness, impaired psychomotor function
Use with caution. Monitor for excessive sedation. Consider non-sedating antihistamines if possible.
Increased sedation, drowsiness, impaired psychomotor function
Use with caution. Monitor for excessive sedation. Consider lower doses of one or both drugs.
Decreased flunarizine plasma levels, reduced therapeutic effect
Monitor for reduced efficacy of flunarizine. Dose adjustment of flunarizine may be necessary.
Additive D2 blockade
Avoid combination, esp. elderly
Source: Kimi deep-research + Cla
Additive sedation
Counsel; avoid alcohol
Source: Kimi deep-research + Cla
Increased plasma concentrations of flunarizine, potentially leading to increased adverse effects such as sedation, dizziness, extrapyramidal symptoms, and depression.
Monitor for increased adverse effects. Consider a lower flunarizine dose or an alternative antidepressant if significant side effects occur.
Increased sedation, drowsiness, respiratory depression
Use with caution. Monitor for excessive sedation and respiratory depression. Consider lower doses of one or both drugs.
Additive parkinsonism
Avoid; monitor
Source: Kimi deep-research + Cla
Decreased flunarizine plasma levels, reduced therapeutic effect
Monitor for reduced efficacy of flunarizine. Dose adjustment of flunarizine may be necessary.
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20