No-Migrain 30 tablets
No-Migrain is a unique combination for the abortive treatment of migraine attacks.
Ergotamine tartrate, is an alpha adrenergic-blocking agent with a direct stimulating effect on the smooth muscles of the peripheral and cranial blood vessels.
Ergotamine is an alkaloid derived from ergot. It has marked vasoconstrictor effects, It is used in migraine and cluster headache.
Caffeine, enhances the ergotamine effect by being a cranial vasoconstrictor and also potentiates the analgesic effect of paracetamol.
Caffeine is sometimes given with ergotamine tartrate with the intention of improving its absorption.
Antiemetics such as cyclizine hydrochloide are sometimes included in combination preparations with ergotamine tartrate.
Caffeine increases mental activity. It may also stimulate the respiratory center.
Caffeine facilitates the performance of muscular work and increases the total work that can be performed by a muscle.
Paracetamol, acts mainly centrally to reduce prostaglandin synthesis in the
brain by inhibiting cycdo-oxygenase enzyme and this accounts for its analgesic effect.
Paracetamol is used for treatment of mild to moderate pain/ Pyrexia, mild to moderate pain in patients with risk factors for hepatotoxicity / Pyrexia in patients with risk factors for hepatotoxicity and pain / Pyrexia with discomfort.
Domperidone, is a peripheral dopamine antagonist that controls nausea and vomiting by blocking the dopamine receptors in the chemoreceptor trigger zone. It is used as an antiemetic for the short-term treatment of nausea and vomiting of various aetiologies. It has been given with paracetamol in the symptomatic treatment of migraine.
Indications:- Abortive and/ or preventive therapy for vascular headache.
- Migraine.
- Migraine variants.
- Histaminic cephalgia.
- Nausea and Vomiting
The tablet should be taken as a whole without division.
For adults and adolescents weighing 35 kg or more: one tablet up to three times daily.
For the best results, dosage should start at the first sign of an attack since success is proportional to rapid treatment and lower doses will be effective.
Side Effects:-Weakness of legs and pain in limb muscles as well as numbness and tingling of fingers and toes may occasionally occur.
Contraindications:- During pregnancy
- Peripheral vascular diseases, coronary heart disease, and hypertension
- Hypersensitivity to any of the components.
- Ketoconazole, erythromycin or other potent CYP3A4 inhibitors which prolong
QTc interval such as fluconazole, voriconazole, clarithromycin and amiodarone.
Warnings and precautions:– Should not be used with other medicines that have similar effects on the heart or reduce the breakdown of domperidone in the body (thus increasing the risk of side effects).
-Signs and symptoms of ergotism rarely develop even after long term intermittent use; care should be exercised to remain within the limits of the recommended dosage.
– The use of domperidone may be associated with an increased risk of serious ventricular arrhythmias or sudden cardiac death, particularly in patients taking daily doses greater than 30 mg, or in patients older than 60 years of age.
– Domperidone should be initiated at the lowest possible dose in adults.
The maximum daily dose of Domperidone is 80 mg.
– In the first months of life and the metabolic functions of the blood brain barrier are not fully developed, the risk of neurological side effects in young children is higher.
– It must not be given to patients with moderate or severe impairment of liver function, or in those who have existing abnormalities of electrical activity in the heart or heart rhythm, or who are at increased risk of such effects.
– Patients should be advised that one tablet is to be taken at the first sign of a migraine headache; followed by one additional tablet every 12 hours if needed, up to 3 tablets per attack. Total weekly dosage should not exceed ten tablets.
-lt should not be used for longer than one week.
– Not to be used in children less than 12 years old.
- Pregnancy and Lactation:
It may be given with caution to breast-feeding and it is contraindicated in pregnancy because ergotamine or its metabolites have been detected in breast milk.
A large amount of data on pregnant woman indicate neither malformation, nor felo/neonatal toxicity. Epidemiological studies on neurodevelopment in children exposed that paracetamol in utero show inconclusive results. If clinically needed, paracetamol can be used during pregnancy, however should be used at the lowest effective dose, for the shortest possible time and at the lowest possible frequency.
- Drug interactions:
No-Migrain should not be administered with other vasoconstrictors.
Use with sympathomimetic may cause elevation of blood pressure.
Storage:Store at a temperature not exceeding 25°C
Package:Carton box holds 3 strips each of 10 film coated tablets and paper leaflet.
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