Availability & Expiry
INTRODUCTION
ZINEPRA 5MG TABLET is a combination of Flunarizine and Propranolol which belongs to the group of medicines called Calcium Channel Blockers and Beta-Blockers respectively. It is used as a prophylactic medication for migraine.
It is a recurring type of headache that causes throbbing or pulsating pain on one side of your head which can be of moderate to severe pain. It is generally characterized by symptoms such as nausea, weakness, sensitivity to light and sound.
ZINEPRA 5MG TABLET is not recommended for use in patients having depressive illness, parkinson’s disease (brain disorder), urinary tract obstruction, low blood pressure, diabetes mellitus, liver impairment, second-or third-degree heart block, bronchial asthma.
Before taking ZINEPRA 5MG TABLET inform your doctor if you have signs of thyrotoxicosis (condition marked by increased production of thyroid hormone) such as experiencing unexplained weight loss, irregular heartbeat, feeling shacky and history of allergic reactions.
Along treatment with ZINEPRA 5MG TABLET your doctor might ask you to make some lifestyle changes such as taking adequate sleep, doing regular exercise and eating balanced diet. ZINEPRA 5MG TABLET is not recommended for use in pregnant and breast-feeding women, which is also not recommended for use in children and adolescents (below 18 years of age).
The most common side effects of taking ZINEPRA 5MG TABLET are increase in body weight, increased appetite, blocked or runny nose, problems with sleeping, sleepiness, nausea and constipation. Consult your doctor if any of the side effect worsens.
USES OF ZINEPRA 5MG TABLET
- Prevents migraine
HOW ZINEPRA 5MG TABLET WORKS
ZINEPRA 5MG TABLET contains flunarizine and propranolol which helps in preventing migraine, where flunarizine works by dilating the blood vessels in the brain and improving blood flow to the brain by preventing throbbing or pulsating pain on one side of your head and propranolol works by preventing the dilation of blood vessels and stabilizing serotonin levels and it effectively reduces the intensity and frequency of migraine attack.
DIRECTIONS FOR USE
Take ZINEPRA 5MG TABLET as advised by your doctor. Swallow ZINEPRA 5MG TABLET with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
SIDE EFFECTS OF ZINEPRA 5MG TABLET
COMMON
- increase in body weight
- increased appetite
- blocked or runny nose
- problems with sleeping
- nausea
- constipation
- stomach-ache or other digestive problems such as irritable bowel syndrome
- muscle ache
- breast pain
- menstrual problems such as irregular periods
- tiredness
- nightmares
- slow heartbeat
- cold fingers and toes, signs of raynaud’s syndrome such as numbness and spasm in the fingers followed by warmth and pain sensation
UNCOMMON
- dry mouth
- feeling disorientated
- blockage in the gut
- indigestion, vomiting
- low blood pressure
- muscle twitches or spasms; twisted neck
- swollen breasts
- unusually heavy periods or scanty periods
- lack of sex drive
- swelling in the hands, legs, feet or other parts of the body
- allergic reaction, skin rash, flushing or hives
RARE
- bruising more easily
- mood changes, confusion, memory loss, psychosis or hallucinations
- tingling sensation
- disturbances of vision, dry eyes
- breathlessness
- swollen ankle
- heart block which may cause an abnormal heartbeat, dizziness, tiredness or fainting
- dizziness particularly on standing up
- worsening of your blood circulation
- worsening of breathing difficulties (if you have asthma)
- hair loss, skin rash, including worsening of itchy skin, purple spots on the skin
Stop taking ZINEPRA 5MG TABLET and consult your doctor immediately if you experience any of the following side effects:
- allergic reaction such as itching, difficulty breathing or swelling of the face, lips, throat or tongue
- intolerance to this medicine (signs include slow heart rate and low blood pressure causing dizziness, light-headedness, fainting or blurred vision)
- tingling or numbness in the hands or feet
- buzzing, hissing, whistling or ringing noise in the ears (tinnitus)
- jerky movements and problems such as slowness, muscle stiffness or rigidity and trembling, twitching or unusual movements of the tongue, face, mouth, jaw or throat
- severe allergic reaction causing a swollen face, lips, mouth, tongue or throat, which may lead to difficulty swallowing or breathing
HOW TO MANAGE SIDE EFFECTS
Nausea:
Take ZINEPRA 5MG TABLET with or just after meals. Stick to simple meals. Avoid eating oily or spicy foods. Consult your doctor if your symptom does not improve.
Tiredness:
Drink plenty of fluids and eat balanced diet and frequent meals. Do regular minimal exercise and follow regular sleep schedule. Consult your doctor if your symptom does not improve.
Constipation:
Take fiber rich foods in your diet such as fresh fruits, vegetables, whole grain cereals and drink plenty of fluids. Exercise more regularly and stay active. Consult your doctor if the symptom does not improve.
Diarrhea:
Drink lot of fluids such as water or fruit juice to keep yourself hydrated. Do not take any medicine on your own for treating diarrhoea without consulting your doctor.
Dry mouth:
Try to drink plenty of cold water. Sip on cold unsweetened drinks and use lip balm if your lips are dry. Try to brush your teeth twice a day and use mouthwash. Consult your doctor if the symptom gets worse.
WARNING & PRECAUTIONS
PREGNANCY
ZINEPRA 5MG TABLET is not recommended for use in pregnant women. Consult your doctor before taking ZINEPRA 5MG TABLET.
BREASTFEEDING
ZINEPRA 5MG TABLET is not recommended for use in breastfeeding women. Consult your doctor before taking ZINEPRA 5MG TABLET.
DRIVING AND USING MACHINES
Do not drive or operate any machines if you feel dizzy, drowsy or tired after taking ZINEPRA 5MG TABLET.
ALCOHOL
Avoid consumption of alcohol while taking ZINEPRA 5MG TABLET as it may cause drowsiness.
KIDNEY
ZINEPRA 5MG TABLET should be used with caution in patients with kidney problems. Consult your doctor before taking ZINEPRA 5MG TABLET.
LIVER
ZINEPRA 5MG TABLET is not recommended for use in patients with liver impairment. It should be used with caution in patients with liver disease such as cirrhosis of the liver. Consult your doctor before taking ZINEPRA 5MG TABLET.
ALLERGY
Do not take ZINEPRA 5MG TABLET if you are allergic to Flunarizine and Propranolol.
LUNGS
ZINEPRA 5MG TABLET is not recommended for use in patients having lung diseases such as bronchial asthma, chronic obstructive pulmonary disease (COPD) or any other breathing difficulties. Consult your doctor before taking ZINEPRA 5MG TABLET.
HEART DISEASE
ZINEPRA 5MG TABLET is not recommended for use in patients having heart diseases such as untreated/uncontrolled heart failure, cardiogenic shock, sinus bradycardia, sick sinus syndrome, second- and third-degree heart block, slow heart rate. It should be used with caution in patients having heart weakness, first degree heart block, hypertrophic cardiomyopathy (thickened heart muscle), prinzmetal’s angina (tight, painful feeling in the chest at the time of rest). Consult your doctor before taking ZINEPRA 5MG TABLET.
OTHERS
ZINEPRA 5MG TABLET is not recommended for use if you have:
- depressive illness or have a history of recurrent depression
- parkinson’s disease (brain disorder) or a similar disease
- signs of raynaud’s syndrome such as cold fingers or toes, color changes in your skin in response to cold or stress
- severe peripheral arterial disease such as numbness, tingling or weakness in the legs, burning or aching pain in the feet or toes while resting
- signs of metabolic acidosis (high acid concentration in body fluids) such as confusion, fast heartbeat, heartbeat
- urinary tract obstruction
- signs of acute porphyria (rare enzymatic defect) such as severe abdominal pain, pain in your chest, legs or back, constipation or diarrhoea
- low blood pressure
- signs of severe blood circulation problems such as tingliness of fingers and toes
- diabetes mellitus
- a strict fasting diet
- suffer from untreated phaeochromocytoma (high blood pressure due to a tumour near the kidney)
Before taking ZINEPRA 5MG TABLET, inform your doctor if you have:
- signs of thyrotoxicosis (condition marked by increased production of thyroid hormone) such as experiencing unexplained weight loss, irregular heartbeat, feeling shacky
- have a phaeochromocytoma (a tumour near the kidney)
- suffer from blood circulation problems (which may cause your fingers and toes to tingle or turn pale or blue)
- history of allergic reactions
Use in Paediatrics:
ZINEPRA 5MG TABLET is not recommended for use in children and adolescents (below 18 years of age). Consult child’s doctor for advice.
Use in Geriatrics:
ZINEPRA 5MG TABLET should be used with caution in elderly patients (aged above 65 years and above) since it may induce depressive illness or parkinson’s disease (brain disorder). Consult your doctor before taking ZINEPRA 5MG TABLET.
INTERACTIONS
A. Drug – Drug interactions:
Before taking ZINEPRA 5MG TABLET, inform your doctor, if you are taking any of the following medicines:
- medicines used to treat anxiety Ex. citalopram, escitalopram, fluvoxamine
- medicines that help in getting sleep such as hypnotics, tranquilizer Ex. diazepam, chlordiazepoxide
- oral contraceptives such as ethinyl estradiol (medicine used to prevent pregnancy)
- medicine used to control high blood pressure Ex. enalapril, lisinopril, perindopril, hydralazine, clonidine, spironolactone, verapamil, diltiazem, nifedipine, nisoldipine, nicardipine, isradipine and lacidipine
- insulin (used to treat diabetes)
- ergotamine, dihydroergotamine, sumatriptan or rizatriptan (used to treat migraine)
- amiodarone, adenosine, disopyramide, quinidine, amiodarone, propafenone (used to treat irregular heartbeat)
- digitalis glycosides such as digoxin (used to treat heart failure)
- adrenaline (used to treat anaphylactic shock)
- lidocaine (used to treat irregular heartbeat or as a local anaesthetic to provide numbing effect before minor procedures)
- cimetidine (used to treat stomach ulcers)
- ibuprofen and indomethacin (used to treat pain and inflammation)
- chlorpromazine and thioridazine (used for psychiatric illness)
- warfarin (used to prevent and treat blood clots)
- rifampicin (used to treat tuberculosis)
- theophylline (used to treat asthma)
Overdosage:
If you or anyone else accidentally take too much of ZINEPRA 5MG TABLET, consult your doctor immediately or visit the nearby hospital. Overdosage symptoms of ZINEPRA 5MG TABLET includes sedation, weakness, difficulty breathing, low blood pressure, drowsiness, fits, dilated pupils, an excessively slowed heartbeat with symptoms such as dizziness, sickness, confusion, hallucinations, body spasms, breathlessness on exertion, fainting or coma.
SYNOPSIS
| Drug | : | Flunarizine, Propranolol |
| Pharmacological Category | : | Calcium Channel Blockers, Beta-Blockers |
| Therapeutic Indication | : | Prophylaxis of migraine |
| Dosage Forms | : | Tablet, Capsule |
MORE INFORMATION
- Keep ZINEPRA 5MG TABLET out of reach of children
- Store ZINEPRA 5MG TABLET at room temperature
FAQs ABOUT ZINEPRA 5MG TABLET
Q: What is ZINEPRA 5MG TABLET and why is it given?
A: ZINEPRA 5MG TABLET is a combination of flunarizine and propranolol which belongs to the group of medicines called calcium channel blockers and beta-blockers respectively, which is used as a prophylactic medication for migraine which is generally characterized by symptoms such as nausea, weakness, sensitivity to light and sound.
Q: Who should avoid taking ZINEPRA 5MG TABLET?
A: ZINEPRA 5MG TABLET is not recommended for use in patients having depressive illness, parkinson’s disease (brain disorder), urinary tract obstruction, low blood pressure, diabetes mellitus, hepatic impairment, second- or third-degree heart block, bronchial asthma, pregnant and breastfeeding women. Consult your doctor before taking ZINEPRA 5MG TABLET.
Q: What are the common side effects of ZINEPRA 5MG TABLET?
A: The most common side-effects of using ZINEPRA 5MG TABLET are increase in body weight, increased appetite, blocked or runny nose, problems with sleeping, sleepiness, nausea and constipation. Consult your doctor if any of these worsens or doesn’t improve.
Q: Does ZINEPRA 5MG TABLET cause weight gain?
A: ZINEPRA 5MG TABLET may cause weight gain when used for longer period of time. Therefore, it is advised to maintain a healthy eating habit and have a balanced diet while taking ZINEPRA 5MG TABLET.
Q: Can ZINEPRA 5MG TABLET be given to children?
A: No, ZINEPRA 5MG TABLET is not recommended for use in children and adolescents (below 18 years of age). If ZINEPRA 5MG TABLET is accidentally ingested by a child or adolescent, go to the hospital immediately and consult the doctor for further management.
REFERENCES
1. KD. Tripathi. 5-Hydroxytryptamine, its Antagonists & Drug Therapy of Migraine and Antiarrhythmic Drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page – 180, 532
2. C J Shimell, V U Fritz, S L Levien. A comparative trial of flunarizine and propranolol in the prevention of migraine. NIH. National Library of Medicine. National center for biotechnology information. Pubmed.gov. January 1990. [Accessed on 6th June 2022] https://pubmed.ncbi.nlm.nih.gov/2404346/
3. Mahsa Shahrokhi, Vikas Gupta. Propranolol. NIH. National Library of Medicine. National center for biotechnology information. StatPearls. May 2022. [Accessed on 6th June 2022] https://www.ncbi.nlm.nih.gov/books/NBK557801/
4. H P Ludin. Flunarizine and propranolol in the treatment of migraine. NIH. National Library of Medicine. National center for biotechnology information. Pubmed.gov. April 1989. [Accessed on 6th June 2022] https://pubmed.ncbi.nlm.nih.gov/2654068/
5. Janssen-Cilag S.p.A. Health Products Regulatory Authority (HPRA). [Revised in March 2020]. [Accessed on 6th June 2022] https://www.hpra.ie/img/uploaded/swedocuments/bc725729-1dcc-48c0-b451-a3149ca2f886.pdf
6. Accord Healthcare. Electronic Medicines Compendium (EMC). [Revised in March 2021]. [Accessed on 6th June 2022] https://www.medicines.org.uk/emc/files/pil.5853.pdf
7. Cipla Ltd. Migarid Tablets (Flunarizine hydrochloride). Ciplamed. [Revised in August 2015]. [Accessed on 6th June 2022] https://www.ciplamed.com/content/migarid-tablets
8. Tasmed India Pvt Ltd. Mibeta-Plus Tablet (Propranolol SR 40 mg + Flunarizine 5/10 mg). [Accessed on 6th June 2022] https://tasmedlab.com/allproduct/mibeta-plus/#dosage
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