CIPLAR PLUS 5 Tablet 10's

Introduction About CIPLAR PLUS 5 TABLET

CIPLAR PLUS 5 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.

CIPLAR PLUS 5 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 CIPLAR PLUS 5 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 management with CIPLAR PLUS 5 TABLET your doctor might ask you to make
some lifestyle changes such as taking adequate sleep, doing regular exercise and
eating balanced diet. CIPLAR PLUS 5 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 CIPLAR PLUS 5 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 CIPLAR PLUS 5 TABLET

• Prevents migraine

How CIPLAR PLUS 5 TABLET Works

CIPLAR PLUS 5 TABLET 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 CIPLAR PLUS 5 TABLET

Take CIPLAR PLUS 5 TABLET as advised by your doctor. Swallow CIPLAR PLUS 5
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 CIPLAR PLUS 5 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 CIPLAR PLUS 5 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 CIPLAR PLUS 5 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 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

CIPLAR PLUS 5 TABLET is not recommended for use in pregnant women. Consult your
doctor before taking CIPLAR PLUS 5 TABLET.

!### Breastfeeding

CIPLAR PLUS 5 TABLET is not recommended for use in breastfeeding women. Consult
your doctor before taking CIPLAR PLUS 5 TABLET.

!### Driving and Using Machines

Do not drive or operate any machines if you feel dizzy, drowsy or tired after
taking CIPLAR PLUS 5 TABLET.

!### Alcohol

Avoid consum
drowsiness.

!### Kidney

CIPLAR PLUS 5 TABLET should be used with caution in patients with kidney
problems. Consult your doctor before taking CIPLAR PLUS 5 TABLET.

!### Liver

CIPLAR PLUS 5 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 CIPLAR PLUS 5
TABLET.

!### Allergy

Do not take CIPLAR PLUS 5 TABLET if you are allergic to Flunarizine and
Propranolol.

!### Lungs

CIPLAR PLUS 5 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 CIPLAR PLUS 5
TABLET.

!### Heart Disease

CIPLAR PLUS 5 TABLET 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 CIPLAR PLUS 5 TABLET.

Others

CIPLAR PLUS 5 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 unmanageed phaeochromocytoma (high blood pressure due to a tumour near the kidney)

Before taking CIPLAR PLUS 5 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:

CIPLAR PLUS 5 TABLET is not recommended for use in children and adolescents
(below 18 years of age). Consult child’s doctor for advice.

Use in Geriatrics:

CIPLAR PLUS 5 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 CIPLAR PLUS 5
TABLET.

Interactions

A. Drug – Drug interactions:

Before taking CIPLAR PLUS 5 TABLET, 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 contrace
• 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 CIPLAR PLUS 5 TABLET,
consult your doctor immediately or visit the nearby hospital. Overdosage
symptoms of CIPLAR PLUS 5 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 CIPLAR PLUS 5 TABLET out of reach of children
• Store CIPLAR PLUS 5 TABLET at room temperature

FAQs About CIPLAR PLUS 5 TABLET

Q: What is CIPLAR PLUS 5 TABLET and why is it given?A: CIPLAR PLUS 5 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 CIPLAR PLUS 5 TABLET?A: CIPLAR PLUS 5 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 CIPLAR PLUS 5 TABLET.

Q: What are the common side effects of CIPLAR PLUS 5 TABLET?A: The most common side-effects of using CIPLAR PLUS 5 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 CIPLAR PLUS 5 TABLET cause weight gain?A: CIPLAR PLUS 5 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 CIPLAR PLUS 5 TABLET.

Q: Can CIPLAR PLUS 5 TABLET be given to children?A: No, CIPLAR PLUS 5 TABLET is not recommended for use in children and
adolescents (below 18 years of age). If CIPLAR PLUS 5 TABLET is accidentally
ingested by a child or adolescent, go to the hospital immediately and consult
the doctor for further management.