MEDICATION SAFETY ISSUES
Sound-alike/look-alike issues:
Midrin® may be confused with midodrine, Mydfrin®
Duplicate therapy issues: This product contains acetaminophen, which may be a component of other combination products. Do not exceed the maximum recommended daily dose of acetaminophen.
U.S. BRAND NAMES — Amidrine [DSC]; Duradrin® [DSC]; Epidrin; Midrin®; Migquin [DSC]; Migratine; Migrazone® [DSC]; Migrin-A [DSC]
PHARMACOLOGIC CATEGORY
Analgesic, Miscellaneous
DOSING: ADULTS
Migraine headache: Oral: 2 capsules to start, followed by 1 capsule every hour until relief is obtained (maximum: 5 capsules/12 hours)
Tension headache: Oral: 1-2 capsules every 4 hours (maximum: 8 capsules/24 hours)
DOSING: ELDERLY — Refer to adult dosing.
DOSING: HEPATIC IMPAIRMENT — Use with caution. Limited, low-dose therapy usually well tolerated in hepatic disease/cirrhosis; however, cases of hepatotoxicity at daily acetaminophen dosages <4 g/day have been reported. Avoid chronic use in hepatic impairment.
DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule: Acetaminophen 325 mg, isometheptene mucate 65 mg, dichloralphenazone 100 mg [DSC]
Amidrine [DSC], Duradrin® [DSC], Epidrin, Midrin®, Migquin [DSC], Migrazone® [DSC], Migratine, Migrin-A [DSC]: Acetaminophen 325 mg, isometheptene mucate 65 mg, and dichloralphenazone 100 mg
DOSAGE FORMS: CONCISE
Capsule:
Epidrin, Midrin®, Migratine: Acetaminophen 325 mg, isometheptene 65 mg, and dichloralphenazone 100 mg
GENERIC EQUIVALENT AVAILABLE — Yes
USE — Relief of migraine and tension headache
ADVERSE REACTIONS SIGNIFICANT — Frequency not defined.
Central nervous system: Dizziness (transient)
Dermatological: Rash
CONTRAINDICATIONS — Hypersensitivity to acetaminophen, isometheptene, dichloralphenazone, or any component of the formulation; glaucoma; severe renal disease; hypertension; organic heart disease; hepatic disease; MAO inhibitor therapy
RESTRICTIONS — C-IV
METABOLISM / TRANSPORT EFFECTS — Acetaminophen: Substrate (minor) of CYP1A2, 2A6, 2C9, 2D6, 2E1, 3A4; Inhibits CYP3A4 (weak)
DRUG INTERACTIONS
Antacids: May decrease the excretion of Alpha-/Beta-Agonists. Exceptions: Aluminum Hydroxide. Risk C: Monitor therapy
Anticonvulsants (Hydantoin): May increase the metabolism of Acetaminophen. This may 1) diminish the effect of acetaminophen; and 2) increase the risk of liver damage. Risk C: Monitor therapy
Atomoxetine: May enhance the hypertensive effect of Sympathomimetics. Atomoxetine may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
Barbiturates: May increase the metabolism of Acetaminophen. This may 1) diminish the effect of acetaminophen; and 2) increase the risk of liver damage. Risk C: Monitor therapy
Beta-Blockers: May enhance the vasopressor effect of Alpha-/Beta-Agonists (Direct-Acting). Epinephrine used as a local anesthetic for dental procedures will not likely cause clinically relevant problems. Management: Cardioselective beta-blockers and lower doses of epinephrine may confer a more limited risk. Patients who may require acute subcutaneous epinephrine (e.g., bee sting kits) should probably avoid beta blockers. Risk D: Consider therapy modification
Bromocriptine: Alpha-/Beta-Agonists may enhance the adverse/toxic effect of Bromocriptine. Including increased blood pressure, ventricular arrhythmias, and seizure. Risk C: Monitor therapy
Cannabinoids: May enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
CarBAMazepine: May increase the metabolism of Acetaminophen. This may 1) diminish the effect of acetaminophen; and 2) increase the risk of liver damage. Risk C: Monitor therapy
Carbonic Anhydrase Inhibitors: May decrease the excretion of Alpha-/Beta-Agonists. Exceptions: Brinzolamide; Dorzolamide. Risk C: Monitor therapy
Cholestyramine Resin: May decrease the absorption of Acetaminophen. Effect is minimal if cholestyramine is administered 1 hour after acetaminophen. Risk D: Consider therapy modification
Imatinib: May increase the serum concentration of Acetaminophen. Risk D: Consider therapy modification
Iobenguane I 123: Sympathomimetics may diminish the therapeutic effect of Iobenguane I 123. Risk X: Avoid combination
Isoniazid: May enhance the adverse/toxic effect of Acetaminophen. Risk C: Monitor therapy
MAO Inhibitors: May enhance the vasopressor effect of Alpha-/Beta-Agonists (Direct-Acting). Primarily with oral administration of phenylephrine. Risk D: Consider therapy modification
Peginterferon Alfa-2b: May decrease the serum concentration of CYP2D6 Substrates. Risk C: Monitor therapy
Serotonin/Norepinephrine Reuptake Inhibitors: May enhance the tachycardic effect of Alpha-/Beta-Agonists. Serotonin/Norepinephrine Reuptake Inhibitors may enhance the vasopressor effect of Alpha-/Beta-Agonists. Risk D: Consider therapy modification
Spironolactone: May diminish the vasoconstricting effect of Alpha-/Beta-Agonists. Risk C: Monitor therapy
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Risk C: Monitor therapy
Tricyclic Antidepressants: May enhance the vasopressor effect of Alpha-/Beta-Agonists (Direct-Acting). Risk D: Consider therapy modification
Vitamin K Antagonists (eg, warfarin): Acetaminophen may enhance the anticoagulant effect of Vitamin K Antagonists. Most likely with daily acetaminophen doses >1.3 g for >1 week. Risk C: Monitor therapy
ETHANOL / NUTRITION / HERB INTERACTIONS — Ethanol: Excessive intake of ethanol may increase the risk of acetaminophen-induced hepatotoxicity. Avoid ethanol or limit to <3 drinks/day.
LACTATION — Excretion in breast milk unknown/use caution
BREAST-FEEDING CONSIDERATIONS — Acetaminophen and dichloralphenazone are excreted in breast milk; excretion of isometheptene is not known.
PRICING — (data from drugstore.com)
Capsules (Epidrin)
325-65-100 mg (100): $63.99
Capsules (Isometheptene-APAP-Dichloral)
65-325-100 mg (30): $22.99
Capsules (Migratine)
325-65-100 mg (100): $37.57
Showing posts with label isometheptene. Show all posts
Showing posts with label isometheptene. Show all posts
Monday, May 17, 2010
Friday, February 29, 2008
Acetaminophen, isometheptene, and dichloralphenazone
U.S. BRAND NAMES — Amidrine [DSC]; Duradrin®; Midrin®; Migquin; Migratine; Migrazone®; Migrin-A
PHARMACOLOGIC CATEGORY Analgesic, Miscellaneous
DOSING: ADULTS Migraine headache: Oral: 2 capsules to start, followed by 1 capsule every hour until relief is obtained (maximum: 5 capsules/12 hours)
Tension headache: Oral: 1-2 capsules every 4 hours (maximum: 8 capsules/24 hours)
DOSING: ELDERLY — Refer to adult dosing.
DOSING: HEPATIC IMPAIRMENT — Use with caution. Limited, low-dose therapy usually well tolerated in hepatic disease/cirrhosis; however, cases of hepatotoxicity at daily acetaminophen dosages <4 g/day have been reported. Avoid chronic use in hepatic impairment.
DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule: Acetaminophen 325 mg, isometheptene mucate 65 mg, dichloralphenazone 100 mg Amidrine [DSC], Duradrin®, Midrin®, Migquin, Migrazone®, Migratine, Migrin-A: Acetaminophen 325 mg, isometheptene mucate 65 mg, and dichloralphenazone 100 mg
DOSAGE FORMS: CONCISE Capsule: Acetaminophen 325 mg, isometheptene 65 mg, dichloralphenazone 100 mg Duradrin®, Midrin®, Migquin, Migrazone®, Migratine, Migrin-A: Acetaminophen 325 mg, isometheptene 65 mg, and dichloralphenazone 100 mg
GENERIC EQUIVALENT AVAILABLE — Yes
USE — Relief of migraine and tension headache
ADVERSE REACTIONS SIGNIFICANT — Frequency not defined.
Central nervous system: Transient dizziness
Dermatological: Rash
CONTRAINDICATIONS — Hypersensitivity to acetaminophen, isometheptene, dichloralphenazone, or any component of the formulation; glaucoma; severe renal disease; hypertension; organic heart disease; hepatic disease; MAO inhibitor therapy
RESTRICTIONS — C-IV
DRUG INTERACTIONS Based on acetaminophen component: Substrate (minor) of CYP1A2, 2A6, 2C9, 2D6, 2E1, 3A4; Inhibits CYP3A4 (weak) Decreased effect: Barbiturates, carbamazepine, hydantoins, rifampin, sulfinpyrazone may decrease the analgesic effect of acetaminophen; cholestyramine may decrease acetaminophen absorption (separate dosing by at least 1 hour) Increased toxicity: Barbiturates, carbamazepine, hydantoins, isoniazid, rifampin, sulfinpyrazone may increase the hepatotoxic potential of acetaminophen; chronic ethanol abuse increases risk for acetaminophen toxicity; effect of warfarin may be enhanced
ETHANOL / NUTRITION / HERB INTERACTIONS — Ethanol: Excessive intake of ethanol may increase the risk of acetaminophen-induced hepatotoxicity. Avoid ethanol or limit to <3 drinks/day.
LACTATION — Excretion in breast milk unknown/use caution
BREAST-FEEDING CONSIDERATIONS — Acetaminophen and dichloralphenazone are excreted in breast milk; excretion of isometheptene is not known.
PRICING — (data from drugstore.com)Capsules (Amidrine) 325-65-100 mg (30): $13.99
Capsules (Migratine) 325-65-100 mg (100): $37.57
Capsules (Migrazone) 325-65-100 mg (100): $38.99
PHARMACOLOGIC CATEGORY Analgesic, Miscellaneous
DOSING: ADULTS Migraine headache: Oral: 2 capsules to start, followed by 1 capsule every hour until relief is obtained (maximum: 5 capsules/12 hours)
Tension headache: Oral: 1-2 capsules every 4 hours (maximum: 8 capsules/24 hours)
DOSING: ELDERLY — Refer to adult dosing.
DOSING: HEPATIC IMPAIRMENT — Use with caution. Limited, low-dose therapy usually well tolerated in hepatic disease/cirrhosis; however, cases of hepatotoxicity at daily acetaminophen dosages <4 g/day have been reported. Avoid chronic use in hepatic impairment.
DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule: Acetaminophen 325 mg, isometheptene mucate 65 mg, dichloralphenazone 100 mg Amidrine [DSC], Duradrin®, Midrin®, Migquin, Migrazone®, Migratine, Migrin-A: Acetaminophen 325 mg, isometheptene mucate 65 mg, and dichloralphenazone 100 mg
DOSAGE FORMS: CONCISE Capsule: Acetaminophen 325 mg, isometheptene 65 mg, dichloralphenazone 100 mg Duradrin®, Midrin®, Migquin, Migrazone®, Migratine, Migrin-A: Acetaminophen 325 mg, isometheptene 65 mg, and dichloralphenazone 100 mg
GENERIC EQUIVALENT AVAILABLE — Yes
USE — Relief of migraine and tension headache
ADVERSE REACTIONS SIGNIFICANT — Frequency not defined.
Central nervous system: Transient dizziness
Dermatological: Rash
CONTRAINDICATIONS — Hypersensitivity to acetaminophen, isometheptene, dichloralphenazone, or any component of the formulation; glaucoma; severe renal disease; hypertension; organic heart disease; hepatic disease; MAO inhibitor therapy
RESTRICTIONS — C-IV
DRUG INTERACTIONS Based on acetaminophen component: Substrate (minor) of CYP1A2, 2A6, 2C9, 2D6, 2E1, 3A4; Inhibits CYP3A4 (weak) Decreased effect: Barbiturates, carbamazepine, hydantoins, rifampin, sulfinpyrazone may decrease the analgesic effect of acetaminophen; cholestyramine may decrease acetaminophen absorption (separate dosing by at least 1 hour) Increased toxicity: Barbiturates, carbamazepine, hydantoins, isoniazid, rifampin, sulfinpyrazone may increase the hepatotoxic potential of acetaminophen; chronic ethanol abuse increases risk for acetaminophen toxicity; effect of warfarin may be enhanced
ETHANOL / NUTRITION / HERB INTERACTIONS — Ethanol: Excessive intake of ethanol may increase the risk of acetaminophen-induced hepatotoxicity. Avoid ethanol or limit to <3 drinks/day.
LACTATION — Excretion in breast milk unknown/use caution
BREAST-FEEDING CONSIDERATIONS — Acetaminophen and dichloralphenazone are excreted in breast milk; excretion of isometheptene is not known.
PRICING — (data from drugstore.com)Capsules (Amidrine) 325-65-100 mg (30): $13.99
Capsules (Migratine) 325-65-100 mg (100): $37.57
Capsules (Migrazone) 325-65-100 mg (100): $38.99
Sunday, January 20, 2008
Acetaminophen, isometheptene, and dichloralphenazone
U.S. BRAND NAMES — Amidrine [DSC]; Duradrin®; Midrin®; Migquin; Migratine; Migrazone®; Migrin-A
PHARMACOLOGIC CATEGORY Analgesic, Miscellaneous
DOSING: ADULTS Migraine headache: Oral: 2 capsules to start, followed by 1 capsule every hour until relief is obtained (maximum: 5 capsules/12 hours)
Tension headache: Oral: 1-2 capsules every 4 hours (maximum: 8 capsules/24 hours)
DOSING: ELDERLY — Refer to adult dosing.
DOSING: HEPATIC IMPAIRMENT — Use with caution. Limited, low-dose therapy usually well tolerated in hepatic disease/cirrhosis; however, cases of hepatotoxicity at daily acetaminophen dosages <4 g/day have been reported. Avoid chronic use in hepatic impairment.
DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule: Acetaminophen 325 mg, isometheptene mucate 65 mg, dichloralphenazone 100 mg Amidrine [DSC], Duradrin®, Midrin®, Migquin, Migrazone®, Migratine, Migrin-A: Acetaminophen 325 mg, isometheptene mucate 65 mg, and dichloralphenazone 100 mg
DOSAGE FORMS: CONCISE Capsule: Acetaminophen 325 mg, isometheptene 65 mg, dichloralphenazone 100 mg Duradrin®, Midrin®, Migquin, Migrazone®, Migratine, Migrin-A: Acetaminophen 325 mg, isometheptene 65 mg, and dichloralphenazone 100 mg
GENERIC EQUIVALENT AVAILABLE — Yes
USE — Relief of migraine and tension headache
ADVERSE REACTIONS SIGNIFICANT — Frequency not defined.
Central nervous system: Transient dizziness
Dermatological: Rash
CONTRAINDICATIONS — Hypersensitivity to acetaminophen, isometheptene, dichloralphenazone, or any component of the formulation; glaucoma; severe renal disease; hypertension; organic heart disease; hepatic disease; MAO inhibitor therapy
RESTRICTIONS — C-IV
DRUG INTERACTIONS Based on acetaminophen component: Substrate (minor) of CYP1A2, 2A6, 2C9, 2D6, 2E1, 3A4; Inhibits CYP3A4 (weak) Decreased effect: Barbiturates, carbamazepine, hydantoins, rifampin, sulfinpyrazone may decrease the analgesic effect of acetaminophen; cholestyramine may decrease acetaminophen absorption (separate dosing by at least 1 hour) Increased toxicity: Barbiturates, carbamazepine, hydantoins, isoniazid, rifampin, sulfinpyrazone may increase the hepatotoxic potential of acetaminophen; chronic ethanol abuse increases risk for acetaminophen toxicity; effect of warfarin may be enhanced
ETHANOL / NUTRITION / HERB INTERACTIONS — Ethanol: Excessive intake of ethanol may increase the risk of acetaminophen-induced hepatotoxicity. Avoid ethanol or limit to <3 drinks/day.
LACTATION — Excretion in breast milk unknown/use caution
BREAST-FEEDING CONSIDERATIONS — Acetaminophen and dichloralphenazone are excreted in breast milk; excretion of isometheptene is not known.
PRICING — (data from drugstore.com)Capsules (Amidrine) 325-65-100 mg (30): $13.99
Capsules (Migratine) 325-65-100 mg (100): $37.57
Capsules (Migrazone) 325-65-100 mg (100): $38.99
PHARMACOLOGIC CATEGORY Analgesic, Miscellaneous
DOSING: ADULTS Migraine headache: Oral: 2 capsules to start, followed by 1 capsule every hour until relief is obtained (maximum: 5 capsules/12 hours)
Tension headache: Oral: 1-2 capsules every 4 hours (maximum: 8 capsules/24 hours)
DOSING: ELDERLY — Refer to adult dosing.
DOSING: HEPATIC IMPAIRMENT — Use with caution. Limited, low-dose therapy usually well tolerated in hepatic disease/cirrhosis; however, cases of hepatotoxicity at daily acetaminophen dosages <4 g/day have been reported. Avoid chronic use in hepatic impairment.
DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule: Acetaminophen 325 mg, isometheptene mucate 65 mg, dichloralphenazone 100 mg Amidrine [DSC], Duradrin®, Midrin®, Migquin, Migrazone®, Migratine, Migrin-A: Acetaminophen 325 mg, isometheptene mucate 65 mg, and dichloralphenazone 100 mg
DOSAGE FORMS: CONCISE Capsule: Acetaminophen 325 mg, isometheptene 65 mg, dichloralphenazone 100 mg Duradrin®, Midrin®, Migquin, Migrazone®, Migratine, Migrin-A: Acetaminophen 325 mg, isometheptene 65 mg, and dichloralphenazone 100 mg
GENERIC EQUIVALENT AVAILABLE — Yes
USE — Relief of migraine and tension headache
ADVERSE REACTIONS SIGNIFICANT — Frequency not defined.
Central nervous system: Transient dizziness
Dermatological: Rash
CONTRAINDICATIONS — Hypersensitivity to acetaminophen, isometheptene, dichloralphenazone, or any component of the formulation; glaucoma; severe renal disease; hypertension; organic heart disease; hepatic disease; MAO inhibitor therapy
RESTRICTIONS — C-IV
DRUG INTERACTIONS Based on acetaminophen component: Substrate (minor) of CYP1A2, 2A6, 2C9, 2D6, 2E1, 3A4; Inhibits CYP3A4 (weak) Decreased effect: Barbiturates, carbamazepine, hydantoins, rifampin, sulfinpyrazone may decrease the analgesic effect of acetaminophen; cholestyramine may decrease acetaminophen absorption (separate dosing by at least 1 hour) Increased toxicity: Barbiturates, carbamazepine, hydantoins, isoniazid, rifampin, sulfinpyrazone may increase the hepatotoxic potential of acetaminophen; chronic ethanol abuse increases risk for acetaminophen toxicity; effect of warfarin may be enhanced
ETHANOL / NUTRITION / HERB INTERACTIONS — Ethanol: Excessive intake of ethanol may increase the risk of acetaminophen-induced hepatotoxicity. Avoid ethanol or limit to <3 drinks/day.
LACTATION — Excretion in breast milk unknown/use caution
BREAST-FEEDING CONSIDERATIONS — Acetaminophen and dichloralphenazone are excreted in breast milk; excretion of isometheptene is not known.
PRICING — (data from drugstore.com)Capsules (Amidrine) 325-65-100 mg (30): $13.99
Capsules (Migratine) 325-65-100 mg (100): $37.57
Capsules (Migrazone) 325-65-100 mg (100): $38.99
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