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Analgesics during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Medical compounds comprised of isometheptene, dichloralphenazone and acetaminophen (Midrin, Amidrin, Migratine) are used to treat vascular headaches or migraines. The combination of isometheptene, a sympathomimetic drug that causes vasoconstriction and dichloralphenazone, a mild sedative, is commonly used during pregnancy. However, no studies of the risk of congenital anomalies are published for either of the two components (isometheptene, dichloralphenazone).
Tension-type headache: diagnosis and treatment
Published in Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby, Headache in Clinical Practice, 2018
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby
Acute therapy, to stop or reduce the severity of the individual attack, consists of the structured use of simple analgesics alone or in combination with caffeine, anxiolytics, or codeine, and nonsteroidal antiinflammatory drugs (NSAIDs). Because of the potential of drug-induced headache, these drugs must be limited (Table 7.2). Optimizing therapy requires knowledge of alternative treatments and awareness of the patient’s preferences. Many acute treatments are available. The choice depends on the severity and frequency of the headaches, the associated symptoms, the presence of coexistent illness, and the patient’s treatment profile. Oral medications, such as analgesics, NSAIDs, or a caffeine adjuvant compound are useful for patients with mild-to-moderate headaches not complicated by nausea. We begin with simple analgesics for patients with mild-to-moderate headaches. Many individuals find headache relief with over-the-counter analgesics such as naproxen sodium, ibuprofen, aspirin, or acetaminophen (paracetamol), alone or in combination with caffeine. When we use prescription drugs, we add butalbital or use the combination of acetaminophen, isometheptene, and dichloralphenazone. Although this combination may be more effective than simple analgesics or NSAIDs, one must be cautious when prescribing butal-bital-containing components since the addiction potential is so high. Because of the risk of dependency, abuse, and CDH, analgesic overuse must be avoided.
Primary Headache Disorders
Published in Mark V. Boswell, B. Eliot Cole, Weiner's Pain Management, 2005
This sympathomimetic with vasoconstrictive effects is found in combination with acetaminophen 325 mg and dichloralphenazone 100 mg. The combination can be effective in migraine without aura. It is taken orally, two capsules at onset headache and one each hour thereafter, to a maximum of five capsules in 1 day. Side effects include drowsiness and nausea, and it is contraindicated in patients with uncontrolled hypertension, with renal disease, or those taking MAO inhibitors.
Reductions in acute medication use and healthcare resource utilization in patients with chronic migraine: a secondary analysis of a phase 3, randomized, double-blind, placebo-controlled study of galcanezumab with open-label extension (REGAIN)
Published in Journal of Medical Economics, 2022
Joshua A. Tobin, Shivang Joshi, Janet H. Ford, Russell M. Nichols, Shonda A. Foster, Dustin Ruff, Holland C. Detke, Sheena K. Aurora
Acute medication use for headache was captured in the daily eDiary. The number of migraine headache days per month with acute headache medication use was a prespecified secondary outcome measure based on patients’ eDiary entries. Allowable headache treatments included acetaminophen (paracetamol); nonsteroidal anti-inflammatory drugs (NSAIDs); triptans; ergotamine and derivatives; isometheptene mucate, dichloralphenazone, and acetaminophen combination (Midrin); or combinations thereof. The following medications were allowed with restrictions: (1) opioid and barbiturates no more than 3 days/month and (2) single dose of injectable steroids allowed only once during the study, in an emergency setting. The name and dose of concomitant medications used for the acute treatment of migraine or headache and the use of other pain medications were captured.
Safety and efficacy of galcanezumab in Taiwanese patients: a post-hoc analysis of phase 3 studies in episodic and chronic migraine
Published in Current Medical Research and Opinion, 2020
Chun-Pai Yang, Chia-Fang Lee, Grazia Dell’Agnello, Hans-Peter Hundemer, Sarah Lipsius, Shuu-Jiun Wang
According to the protocols for both EVOLVE-2 and REGAIN the concomitant use of acute medications to treat migraine was allowed, inclusive of the following: acetaminophen (paracetamol), NSAIDs; triptans; ergotamine and derivatives; isometheptene mucate, dichloralphenazone and acetaminophen combination (Midrin); or combinations thereof. Use of opioid- and barbiturate-containing medications was restricted to no more than 3 days per month, and a single dose of injectable steroids was allowed only once during the study, in an emergency setting.