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Migraine Combinations Drug - Its Side Effects

Type of Drug:

Combinations of drugs used to treat migraine attacks.

How the Drug Works:

Ergotamine tart rate, caffeine, and isometheptene constrict blood vessels in the brain, an action that may be related to the relief of migraines. For more information on caffeine, see the CNS Stimulants-Caffeine monograph in this chapter.

Acetaminophen and aspirin are used for their pain relieving effect. For more information, see the Analgesics-Acetaminophen and Analgesics-Aspirin and Salicylates monographs in this chapter.

Belladonna alkaloids are used to treat nausea and vomiting during migraine attacks.

Barbiturates and dichloralphenazone are used for sedation to reduce the emotional reaction to migraine pain. For more information on barbiturates, see the Sedatives-Barbiturates monograph in this chapter.

Uses:

To stop or prevent vascular (migraine) headaches.

Isomothoptono: or relief of tension and vacular (migrain) headaches.

Precautions:

Pregnancy: Do not use ergotamine/caffeine products if you are pregnant or planning to become pregnant. Use isometheptene, dichloralphenazone, or acetaminophen products only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if ergotamine is excreted in breast milk.

Children: Safety and effectiveness of use of ergotamine in children have not been established.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements while taking a migraine combination. Doses of one or bottle drugs may need to be modified or a different drug may need to be proscribed. The following drugs and drug classes interact with migraine com binations containing belladonna alkaloids or ergotamine. For more information on other agents, see the individual monographs.

  • Beta-blockers (eg, propranolol) (ergotamine only)

  • Haloperidol (eg, Haldot) (belladonna only)

  • Macrolide antibiotics (eg, erythromycin) (ergotamine only)

  • MAOls (eg, phenelzine) (isometheptene only)

  • NNRT inhibitors (eg, delavirdine) (ergotamine only)

  • Phenothiazines (eg, perphenazine) (belladonna only)

  • Protease inhibitors (eg, ritonavir) (ergotamine only)

  • Selective 5-HT 1 receptor ago­nists (eg, sumatriptan) (ergot­amine only)

Side Effects:

Every drug is capable of producing side effects. Many migraine combination users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Ergotamine - Chest pain, muscle pain in the arms and legs, numbness and tingling in fingers and toes; cold or pale fingers or toes, abnormal heart rhythm, vomiting, nausea, weakness in the legs, diarrhea, localized swelling and itching, vertigo (feeling of whirling motion), rectal or anal ulcer (due to overuse of suppositories).

Isometheptene - Dizziness, rash.

Guidelines for Use:

  • Dosage is individualized. Take exactly as prescribed.

  • Do not stop taking or change the dose, unless directed by your doctor.

  • Take at the first sign or "hint" of a migraine attack.

  • Suppositories are used when tablets and capsules cannot be taken because the migraine attack caused nausea or vomiting.

  • Ergotamine products - Stop taking and notify your doctor if you experience numbness, tingling, coldness, or paleness in fingers or toes; muscle pain in arms or legs; weakness in legs; chest pain; heart rate changes; sudden worsening of headache; swelling; or itching.

  • Store tablets and capsules at room temperature. Protect from moisture.

  • Store suppositories below 77°F in the foil wrapper. If suppository is soft, chill in the refrigerator before opening.

 

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