Grain OX Tablet SR is a sustained-release formulation combining Propranolol 40 mg and Flunarizine 10 mg, designed for the management of migraine prophylaxis and certain cardiovascular conditions. Propranolol, a non-selective beta-adrenergic blocker, exerts its therapeutic effects by reducing heart rate, myocardial contractility, and systemic blood pressure, thereby decreasing cardiac workload and oxygen demand. It is widely used in the prevention of migraine attacks, essential hypertension, angina pectoris, and arrhythmias. Flunarizine, a selective calcium channel blocker with antihistaminic properties, acts by inhibiting the influx of calcium ions into vascular smooth muscle and neuronal cells, stabilizing vascular tone and reducing neuronal excitability. This dual-action combination enhances efficacy in migraine prevention by addressing both vascular and neuronal mechanisms implicated in migraine pathophysiology. Grain OX Tablet SR’s sustained-release matrix ensures a gradual and consistent release of active ingredients, promoting improved patient compliance through once-daily dosing and minimizing peak-related side effects. It is contraindicated in patients with asthma, bradycardia, severe hypotension, or known hypersensitivity to either component. Caution is advised in patients with hepatic or renal impairment. Common adverse effects may include fatigue, dizziness, gastrointestinal disturbances, and peripheral edema. Regular monitoring of cardiovascular parameters is recommended during therapy.