Nomigam
Nomigam Uses, Dosage, Side Effects, Food Interaction and all others data.
Nomigam is the difluorinated derivative of cinnarizine. It is a seletive calcium channel antagonist and has H1-receptor blocking action. By reducing excessive transmembrane influx of calcium Nomigam prevents cellular calcium overlod. It does not interfere with normal cellular calcium homeostasis. Nomigam also has some antihistaminic and sedative properties.
Nomigam is a selective calcium entry blocker with calmodulin binding properties and histamine H1 blocking activity.
| Trade Name | Nomigam |
| Generic | Flunarizine |
| Flunarizine Other Names | Flunarizina, Flunarizine, Flunarizinum |
| Type | Tablet |
| Formula | C26H26F2N2 |
| Weight | Average: 404.4948 Monoisotopic: 404.206405252 |
| Protein binding | 99% bound to plasma proteins |
| Groups | Approved |
| Therapeutic Class | Miscellaneous prophylactic migraine preparations |
| Manufacturer | Sundyota Numandis Pharma Pvt Ltd |
| Available Country | India |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Nomigam is used for
- Prophylaxis of classic (with aura) or common (without aura) migraine
- Symptomatic treatment of vestibular vertigo (due to a diagnosed functional disorder of the vestibular system).
- Peripheral Vascular Disease (PVD)
- Motion sickness
- Refractory epilepsy resistant to conventional antiepileptic therapy.
Nomigam is also used to associated treatment for these conditions: Severe Migraine
How Nomigam works
Nomigam inhibits the influx of extracellular calcium through myocardial and vascular membrane pores by physically plugging the channel. The decrease in intracellular calcium inhibits the contractile processes of smooth muscle cells, causing dilation of the coronary and systemic arteries, increased oxygen delivery to the myocardial tissue, decreased total peripheral resistance, decreased systemic blood pressure, and decreased afterload.
Dosage
Nomigam dosage
Migraine Prophylaxis:
- Starting Dose: 10 mg at night in patients less than 65 years of age and 5 mg daily in patients older than 65 years. If, during this treatment depressive, extrapyramidal or other unacceptable symptoms occur, administration should be discontinued. If, after 2 months of this initial treatment, no significant improvement is observed, the patient should be considered a non-responder and administration should be discontinued.
- Maintenance Treatment: If a patient is responding satisfactorily and if a maintenance treatment is needed, the dose should be decreased to 5 days treatment at the same daily dose with two successive medicine free days every week. Even if the prophylactic maintenance treatment is successful and well tolerated, it should be interrupted after 6 months and it should be re-initiated only if the patient relapses.
Peripheral Vascular disease: 10 mg twice daily, up to 30 mg per day if required.
Vertigo & motion sickness: 10-20 mg daily for adults and 5 mg daily for children (> 40 kg).
Epileptic seizure: 15-20 mg daily in adults and 5 to 10 mg daily for children as an add-on therapy
Side Effects
Nomigam is well tolerated and seldom causes serious side effects. The main adverse effects experienced by the patients are as follows:
Central nervous system: Depression, drowsiness, sedation, and anxiety.
Gastrointestinal: Heart burn, nausea, emesis, dry mouth, gastralgia.
Miscellaneous: Weight gain, and/or increased appetite, asthenia, muscle aches, skin rash, and galactorrhea in female patients on oral contraceptives.
Toxicity
-Nomigam should be used with care in patients with depression or those being prescribed other agents, such as phenothiazines, concurrently, which may cause extrapyramidal side-effects. -Acute overdosage has been reported and the observed symptoms were sedation, agitation and tachycardia. -Treatment of acute overdosage consists of charcoal administration, induction of emesis or gastric lavage, and supportive measures. No specific antidote is known.
Precaution
Since sedation or drowsiness occur in some patients during treatment with flunarizine hydrochloride, patients should be cautioned against activities which require alertness or rapid, precise responses (e.g. operating machinery or a motor vehicle) until the response to the drug has been determined.
Interaction
Galactorrhoea has been reported in few women on oral contraceptives within the first two months of Nomigam treatment. Hepatic enzyme inducers such as Carbamazepine and Phenytoin may interact with flunarizine by increasing its metabolism. So an increase in dosage of flunarizine may be required.
Food Interaction
- Avoid alcohol.
- Take with or without food. The absorption is unaffected by food.
Elimination Route
85% following oral administration.
Half Life
18 days
Pregnancy & Breastfeeding use
Safety in pregnancy and lactation has not been established.
Contraindication
Hypersensitivity to Nomigam. Nomigam is contra-indicated in patients with a history of depressive illness, or with pre-existing symptoms of Parkinson's disease or other extrapyramidal disorders.
Storage Condition
Store at a cool & dry place, protected from light and moisture. Keep out of reach of the children.
Innovators Monograph
You find simplified version here Nomigam
FAQ
What is Nomigam used for?
Nomigam is a selective calcium entry blocker with calmodulin binding properties and histamine H1 blocking activity. It is effective in the prophylaxis of migraine, occlusive peripheral vascular disease, vertigo of central and peripheral origin, and as an adjuvant in the therapy of epilepsy.
How safe is Nomigam?
Nomigam may be safe, effective, and well-tolerated as a prophylactic treatment for episodic migraine, according to a systematic review and pooled meta-analysis published in Pain.
How does Nomigam work?
Nomigam is a selective calcium entry blocker with calmodulin binding properties and histamine H1 blocking activity. Nomigam inhibits the influx of extracellular calcium through myocardial and vascular membrane pores by physically plugging the channel.
What are the common side effects of Nomigam?
The common side effects of Nomigam are tiredness, drowsiness, weight gain and low mood. Possible weight gain is caused by an increase in appetite and can be avoided by your child following his or her usual diet without any increase in portion size.
Is Nomigam safe during pregnancy?
Nomigam probably is compatible with pregnancy.
Is Nomigam safe during breastfeeding?
No information is available on the use of Nomigam during breastfeeding.
Can I drink alcohol with Nomigam?
Alcohol may increase the risk of tiredness and drowsiness with Nomigam. If you do feel tired or drowsy whilst taking Nomigam, you should avoid alcoholic drinks.
Can I drive after taking Nomigam?
Nomigam may cause drowsiness. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.
When should be taken of Nomigam?
Nomigam should be taken at night-time starting with a low dose. This may then be increased as recommended by the doctor. You should encourage your child to continue with the medicine as it may not take full effect for about eight to 12 weeks.
How often can I take Nomigam?
The recommended adult dose of Nomigam is 10 mg daily taken in the evening with or without food. Those who have side effects may find 5 mg daily in the evening to be effective.
How long does Nomigam take to work?
It may take 6 to 8 weeks of continued treatment before the maximum effect of this Nomigam is noted.
How long does Nomigam take to work?
Nomigam has a long elimination half-life of about 19 days.
How long does Nomigam last?
Nomigam will usually be used for at least six months but you will be advised further about this by your doctor.
Who should not take Nomigam?
Nomigam should not be taken by people with depression or by people with Parkinson's disease or movement disorders.
Can Nomigam increase blood pressure?
Nomigam is reported to produce only slight decreases of systemic arterial blood pressure.
Does Nomigam cause depression?
In contrast, Nomigam, a calcium-channel antagonist used for acute and prophylactic treatment of migraine headaches, has been associated with depression.
Can I just stop taking Nomigam?
It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your doctor or pharmacist first. It must be used regularly and continuously to maintain its beneficial effects.
What happen If I missed dose of Nomigam?
If you miss a dose, take it as soon as remembered; do not take it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not double-up the dose to catch up.
What happens if I overdose?
Symptoms of overdose may include confusion, unusual drowsiness, and rapid pulse.
Can Nomigam affects my heart ?
Nomigam caused an increase in heart rate following the administration of the higher doses.
