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Introduction About MIGIPLEX
MIGIPLEX 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.
MIGIPLEX 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 MIGIPLEX 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 management with MIGIPLEX your doctor might ask you to make some lifestyle changes such as taking adequate sleep, doing regular exercise and eating balanced diet. MIGIPLEX 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 MIGIPLEX 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 MIGIPLEX
- Prevents migraine
How MIGIPLEX Works
MIGIPLEX contains flunarizine and propranolol which helps in managing migraine, where flunarizine works by dilating the blood vessels in the brain and improving blood flow to the brain by managing throbbing or pulsating pain on one side of your head and propranolol works by managing the dilation of blood vessels and stabilizing serotonin levels and it effectively reduces the intensity and frequency of migraine attack.
How to use MIGIPLEX
Take MIGIPLEX as advised by your doctor. Swallow MIGIPLEX 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 MIGIPLEX
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 MIGIPLEX 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 MIGIPLEX 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 managing 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
MIGIPLEX is not recommended for use in pregnant women. Consult your doctor before taking MIGIPLEX.
Breastfeeding
MIGIPLEX is not recommended for use in breastfeeding women. Consult your doctor before taking MIGIPLEX.
Driving and Using Machines
Do not drive or operate any machines if you feel dizzy, drowsy or tired after taking MIGIPLEX.
Alcohol
Avoid consumption of alcohol while taking MIGIPLEX as it may cause drowsiness.
Kidney
MIGIPLEX should be used with caution in patients with kidney problems. Consult your doctor before taking MIGIPLEX.
Liver
MIGIPLEX 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 MIGIPLEX.
Allergy
Do not take MIGIPLEX if you are allergic to Flunarizine and Propranolol.
Lungs
MIGIPLEX 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 MIGIPLEX.
Heart Disease
MIGIPLEX is not recommended for use in patients having heart diseases such as unmanageed/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 MIGIPLEX.
Others
MIGIPLEX 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 unmanageed phaeochromocytoma (high blood pressure due to a tumour near the kidney)
Before taking MIGIPLEX, 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:
MIGIPLEX is not recommended for use in children and adolescents (below 18 years of age). Consult child’s doctor for advice.
Use in Geriatrics:
MIGIPLEX 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 MIGIPLEX.
Interactions
A. Drug – Drug interactions:
Before taking MIGIPLEX, inform your doctor, if you are taking any of the following medicines:
- medicines used to manage 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 manage 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 manage diabetes)
- ergotamine, dihydroergotamine, sumatriptan or rizatriptan (used to manage migraine)
- amiodarone, adenosine, disopyramide, quinidine, amiodarone, propafenone (used to manage irregular heartbeat)
- digitalis glycosides such as digoxin (used to manage heart failure)
- adrenaline (used to manage anaphylactic shock)
- lidocaine (used to manage irregular heartbeat or as a local anaesthetic to provide numbing effect before minor procedures)
- cimetidine (used to manage stomach ulcers)
- ibuprofen and indomethacin (used to manage pain and inflammation)
- chlorpromazine and thioridazine (used for psychiatric illness)
- warfarin (used to manage blood clots)
- rifampicin (used to manage tuberculosis)
- theophylline (used to manage asthma)
Overdosage:
If you or anyone else accidentally take too much of MIGIPLEX, consult your doctor immediately or visit the nearby hospital. Overdosage symptoms of MIGIPLEX 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 MIGIPLEX out of reach of children
- Store MIGIPLEX at room temperature
FAQs About MIGIPLEX
Q: What is MIGIPLEX and why is it given?
A: MIGIPLEX 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 MIGIPLEX?
A: MIGIPLEX 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 MIGIPLEX.
Q: What are the common side effects of MIGIPLEX?
A: The most common side-effects of using MIGIPLEX 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 MIGIPLEX cause weight gain?
A: MIGIPLEX 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 MIGIPLEX.
Q: Can MIGIPLEX be given to children?
A: No, MIGIPLEX is not recommended for use in children and adolescents (below 18 years of age). If MIGIPLEX 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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