Migranil is a tricyclic compound that competitively blocks serotonin receptors. It also has antihistamine, antibradykinin, and mild anticholinergic actions, along with appetite-stimulating effects.
Migranil is used for the prevention of vascular headaches of the migraine type, including classical migraine, common migraine, and cluster headache. It is not effective for treating migraine attacks that have already started.
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Pizotifen, the active ingredient in Migranil, works by blocking the peripheral effects of serotonin and histamine that increase the permeability of cranial vessel membranes and cause fluid leakage (plasmakinin transudation), while also modifying pain thresholds in migraine. By blocking 5-HT receptors, it reduces serotonin’s role in cranial vasoconstriction and platelet aggregation. It may also block the peripheral effects of bradykinin and inhibit serotonin reuptake in platelets, which reduces the tone and distension of extracranial arteries. Appetite stimulation may result from metabolic effects rather than direct action on appetite centers.
Dosage & Administration
Adults: Typically 1.5 mg daily, either as a single bedtime dose or in three divided doses. The dose can be adjusted up to 4.5 mg per day, with a maximum of 3 mg as a single dose.
Children (over 2 years): Up to 1.5 mg daily in divided doses; up to 1 mg may be given as a single bedtime dose.
Use only as directed by a registered physician.
Drug Interactions
Sedatives, hypnotics, antihistamines (including some cold remedies), and alcohol may have enhanced central effects when taken with Migranil. The drug may also counteract the blood pressure-lowering effects of adrenergic neurone blockers.
Contraindications
Not to be used in patients with hypersensitivity to any component of the formulation.
Side Effects
The most frequently reported effects are increased appetite, weight gain, and drowsiness.
Pregnancy & Lactation
Limited data are available on the use of pizotifen during pregnancy, and although no harmful effects have been reported, it should only be used if the potential benefits outweigh possible risks to the fetus. Safety during breastfeeding has not been established, so its use is not recommended for nursing mothers.
Precautions & Warnings
Caution is advised in patients with urinary retention or renal impairment. Drowsiness may impair the ability to drive or operate machinery. Alcohol’s effects are increased when taken with Migranil.
Therapeutic Class
Anti-histamine preparations, other drugs for migraine.
Storage
Store in a cool, dry place away from heat and light. Keep out of reach of children.
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