Migraine Management with Naproxen and Flunarizine

Pharmacological Roles

The American Academy of Family Physicians recommends naproxen as a non-steroidal anti-inflammatory drug (NSAID) primarily used for acute migraine attacks, with a recommended dosage of 275-550 mg every 2-6 hours 3, 4
The American College of Physicians suggests that naproxen shows modest efficacy in migraine prevention when used regularly, though primarily indicated for acute treatment 1
The American Academy of Neurology indicates that flunarizine, a calcium channel blocker, has proven efficacy in migraine prevention at 10 mg/day 1, 2

The American Gastroenterological Association notes that naproxen commonly causes gastrointestinal symptoms, including nausea, vomiting, gastritis, and blood in stool, reported in 3-45% of participants in clinical trials 1, 2
The American Heart Association indicates that flunarizine can cause abdominal pain as a side effect, and potential concern for additive gastrointestinal irritation when used concurrently with naproxen 1, 2

The American Academy of Family Physicians recommends monitoring for increased gastrointestinal symptoms when using both medications concurrently, and being vigilant for signs of depression, especially in elderly patients taking flunarizine 1, 2
The American College of Physicians suggests considering the timing of administration, with flunarizine preferably taken at night to minimize sedation 5

The American Headache Society recommends starting flunarizine at 10 mg daily, preferably at night, and using naproxen at the lowest effective dose for acute attacks to minimize potential side effects 4, 5
The American Gastroenterological Association advises monitoring for gastrointestinal symptoms, which may be the most likely overlapping adverse effect, and being aware that elderly patients may be more susceptible to side effects of both medications 1, 2