— Product
MIGRAINIL TAB
ERGO + PCP + PARA + CAFF TAB
MIGRAINIL TAB is a tablet combining ergotamine, prochlorperazine, paracetamol and caffeine, for the acute treatment of migraine. It combines a vasoconstrictor that aborts the migraine attack, an antiemetic for the accompanying nausea, an analgesic and caffeine to aid absorption.
01
Benefits
- Ergotamine constricts the dilated cranial blood vessels of a migraine attack, an established mechanism for aborting the headache.
- Prochlorperazine treats the nausea and vomiting that accompany migraine and that often prevent oral medication being kept down.
- Paracetamol adds analgesia for the headache itself.
- Caffeine improves ergotamine absorption and has a modest analgesic-enhancing effect of its own.
- Addresses the headache, the nausea and the absorption problem together, which single-agent treatment does not.
02
Side effects
Not everyone gets these. Most are mild and settle as the course finishes.
Common
- Nausea or vomiting
- Drowsiness
- Dizziness
- Tingling or coldness of the hands and feet
Less common
- Muscle cramps or leg pain
- Abdominal pain
- Restlessness or difficulty sleeping
- Dry mouth or blurred vision
Stop and get medical help if any of these occur
- Numbness, tingling, coldness, pallor or blueness of the fingers or toes — signs of ergotism, which can cause tissue loss
- Chest pain, or leg pain on walking
- Severe or persistent vomiting
- Muscle stiffness, tremor, restlessness or involuntary movements of the face and tongue
- Sudden severe headache unlike the usual migraine, or headache with fever, neck stiffness or weakness
03
Precautions
- Ergotamine must not be overused. Taking it more than about twice a week causes medication-overuse headache, and cumulative use causes ergotism with serious peripheral vasoconstriction.
- Contraindicated in ischaemic heart disease, peripheral vascular disease, uncontrolled hypertension, sepsis, and severe hepatic or renal impairment.
- Contraindicated absolutely in pregnancy — ergotamine causes uterine contraction and fetal harm — and in breastfeeding.
- Contraindicated with potent CYP3A4 inhibitors including macrolide antibiotics, azole antifungals and protease inhibitors; the combination causes severe ergotism.
- Do not use with triptans, or within 24 hours of one, as the vasoconstrictor effects are additive.
- Prochlorperazine can cause acute dystonic reactions, particularly in young patients — muscle spasm of the face, neck or eyes needs immediate treatment.
- Check total daily paracetamol intake across all products.
- Take at the first sign of an attack; ergotamine is far less effective once the headache is established. Causes drowsiness — warn before driving.