Dulonor 10 Tablet

Dulonor 10 Tablet contains Flunarizine, a medication primarily used for the prophylaxis (prevention) of migraine headaches. It is a selective calcium entry blocker and is effective in reducing the frequency and severity of migraine attacks. It is not intended to treat an acute migraine attack already in progress. It is also sometimes used in the management of dizziness and vertigo caused by inner ear problems (vestibular disorders). Because of the potential for certain side effects, especially depression and movement disorders, Flunarizine is generally considered a second-line treatment, used when other therapies have failed or are not tolerated. Treatment is usually prescribed for a specific duration, after which efficacy is re-evaluated.

Dulonor 10 Tablet contains Flunarizine, which belongs to a class of drugs known as calcium channel blockers (specifically, a non-selective calcium antagonist). This drug acts by stabilising neuronal and vascular membranes. It prevents excessive influx of calcium ions into cells, which helps protect the brain and blood vessels from the detrimental effects of conditions like reduced oxygen supply (ischemia).

In migraine prophylaxis, the dosage is typically taken once daily, usually in the evening. Flunarizine works over time to decrease the hyperexcitability of the brain cells and to stabilise the tone of the cranial blood vessels, which are thought to be key factors in triggering migraine attacks. It can take several weeks of continuous use to observe a significant reduction in migraine frequency.

Due to its mechanism, it is crucial to use this medicine exactly as prescribed and to monitor for side effects, particularly changes in mood or any unusual physical movements, as these may require prompt consultation with your prescribing physician.

Dulonor 10 Tablet is used for:

Migraine Prophylaxis:

Reducing the frequency and severity of classic (with aura) or common (without aura) migraine headaches.

Symptomatic Treatment of Vertigo and Dizziness:

Managing symptoms associated with peripheral vestibular disorders (inner ear balance issues). This is generally done when other medications or interventions have not been effective.

Migraine Prevention:

Effectively reduces the number of days a patient experiences migraine attacks per month, leading to an improved quality of life.

Reduced Severity:

When migraine attacks do occur, they are often less severe and debilitating.

Convenient Dosing:

The 10mg dose is typically taken just once daily, making adherence simple.

Dual Action:

Offers relief for both migraines and specific forms of vertigo.

When initiating therapy with Dulonor 10 Tablet, side effects are usually mild and manageable, but monitoring for more serious reactions is vital.

Common Side Effects (Often Dose-Related):

• Weight gain (very common)

• Increased appetite

• Drowsiness, fatigue, or tiredness

• Nasal congestion

• Trouble sleeping (insomnia)

Serious Side Effects (Stop taking the medicine and seek urgent medical attention if you experience):

• Depression: Severe mood changes, feelings of hopelessness, or suicidal thoughts.

• Extrapyramidal Symptoms (EPS) / Movement Disorders: Tremors, stiffness, shuffling gait, difficulty initiating movement, restlessness (akathisia), or involuntary repetitive movements. This risk increases with dose and prolonged use.

• Severe Allergic Reaction: Rash, hives, swelling of the face, throat, or tongue, or difficulty breathing.

• Liver Issues: Yellowing of the skin or eyes (jaundice), persistent nausea, or unexplained fatigue.

Always take Dulonor 10 Tablet exactly as prescribed by your doctor. The doctor will usually start you on a lower dose and may increase it if necessary.

• Dosage: The standard dose for migraine prevention is one 10mg tablet daily, typically taken in the evening.
• Timing: It is often recommended to take the medicine in the evening due to its common side effect of drowsiness.
• Swallowing: Swallow the tablet whole with a glass of water. It can be taken with or without food.
• Consistency: Take the medication at the same time each day to maintain consistent drug levels.
• Duration: After 6 months of continuous treatment, if the attacks have not significantly improved, your treatment will likely be discontinued. If it has been effective, your doctor may consider reducing the dose or planning a break.

• Patience is Key: Flunarizine is a preventative medicine, not an acute treatment. It may take 4 to 8 weeks to notice a significant reduction in migraine attacks. Continue taking it as prescribed even if you don't see immediate results.
• Monitor Mood: Be vigilant for signs of depression, especially if you have a history of mood disorders. Report any changes in mood, unusual tiredness, or feelings of sadness to your doctor immediately.
• Track Movement: Pay attention to new or unusual movements (tremors, restlessness, slow movement). These are signs of extrapyramidal symptoms and require urgent medical review.
• Avoid Abrupt Stops: Do not stop taking Dulonor 10 Tablet suddenly, as this may lead to withdrawal effects or a rebound increase in migraine frequency. Your doctor will advise you on gradually reducing the dose.
• Evening Dosing: Taking the dose in the evening can help mitigate the daytime drowsiness side effect.

• Store Dulonor 10 Tablet at normal room temperature, typically between 15 °C and 30 °C.
• Keep the medicine in the original blister pack, protected from excessive moisture, heat, and direct light.
• Keep the tablets out of the reach and sight of children and pets.
• Do not use the medication past the expiry date printed on the packaging.

There are no significant drug-food interactions with Dulonor 10 Tablet. It can be taken with or without food.

• The following drugs may interact with Dulonor 10 Tablet and require caution:
• CNS Depressants (e.g., Sedatives, Sleeping Pills, Strong Painkillers): Concomitant use with Flunarizine increases the risk of excessive sedation, drowsiness, and impaired alertness.
• Anticonvulsants (e.g., Carbamazepine, Phenytoin): These drugs can accelerate the metabolism of Flunarizine, potentially reducing its effectiveness. The dose of Flunarizine may need adjustment.
• Oral Contraceptives: Flunarizine may slightly increase the plasma concentration of progestins and oestrogens, but this effect is generally considered low risk.

Caution is required for patients with:

• Depressive Illness: Flunarizine can exacerbate (worsen) depressive symptoms. It is usually contraindicated in patients with a history of recurrent depression.
• Parkinson's Disease or Extrapyramidal Disorders: Due to the risk of causing or aggravating movement disorders, Flunarizine should be avoided or used with extreme caution in these patients.
• Liver Impairment: Flunarizine is metabolised (broken down) in the liver. Dose adjustment may be necessary in patients with significant liver disease.

The standard recommended starting and maintenance dose for adults (under 65 years) for migraine prophylaxis is 10mg once daily, usually in the evening.

• Crucial Dosing Rule:
• Titration: Treatment is often started at 5mg daily for older patients (over 65) or patients with high-risk factors.
• Maintenance: After 1-2 months of continuous use, if the symptoms have not improved, the doctor may increase the dose or decide to stop treatment.

If you think you or someone else has taken too much Dulonor 10 Tablet, seek emergency medical help immediately. Overdose symptoms may include profound sedation, excessive drowsiness, and potentially confusion or agitation. A very large overdose can lead to low blood pressure (hypotension) and a fast heart rate (tachycardia). Medical monitoring and supportive care are essential.

If you miss a scheduled dose of Dulonor 10 Tablet, take it as soon as you remember. However, if it is already time for your next scheduled dose, skip the missed dose completely. Do not take a double dose to make up for the missed one. Simply continue with your regular dosing schedule.