Isometheptene Mucate / Dichloralphenazone / Acetaminophen
Pronunciation: eye-so-meth-EPP-teen MYOO-kate/die-klor-uhl-FEN-uh-zone/ASS-et-ah-MEE-noe-fen
Class: Migraine combination
Trade Names
Epidrin
- Capsules 65 mg isometheptene mucate, 100 mg dichloralphenazone, 325 mg APAP
Midrin
- Capsules 65 mg isometheptene mucate, 100 mg dichloralphenazone, 325 mg APAP
Migratine
- Capsules 65 mg isometheptene mucate, 100 mg dichloralphenazone, 325 mg APAP
Pharmacology
Isometheptene mucate acts as sympathomimetic to constrict dilated cranial and cerebral arterioles. Dichloralphenazone is a mild sedative that reduces emotional reaction to pain of vascular and tension headaches. Acetaminophen is a mild analgesic.
Indications and Usage
Relief of tension and vascular headaches. FDA has classified drug as possibly effective in treatment of migraine headaches.
Contraindications
Glaucoma; severe cases of renal disease; hypertension; organic heart disease; hepatic disease; MAOI therapy.
Dosage and Administration
Migraine HeadacheAdults
PO 2 capsules at once, followed by 1 capsule every h until headache is relieved (max, 5 capsules in 12 h period).
Tension HeadacheAdults
PO 1 to 2 capsules every 4 h (max, 8 capsules/day).
General Advice
- Administer at first sign of migraine headache.
- Administer with full glass of water.
Storage/Stability
Store at room temperature in dry place in tightly closed container.
Drug Interactions
MAOIsMay result in severe headache, hypertension, hyperpyrexia, and possible hypertensive crisis.
Laboratory Test Interactions
None well documented.
Adverse Reactions
CNS
Transient dizziness or drowsiness.
Dermatologic
Rash.
Precautions
WarningsThese products contain acetaminophen. Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplant and death. Most of the cases of liver injury are associated with the use of acetaminophen at doses that exceed 4,000 milligrams per day, and often involve more than one acetaminophen-containing product. |
Pregnancy
Pregnancy category undetermined.
Lactation
Undetermined.
Children
Safety and efficacy not established.
Special Risk Patients
Observe caution in patients with hypertension or peripheral vascular disease and after recent CV attacks.
Hepatotoxicity
Can occur with chronic ingestion of acetaminophen. Chronic alcohol abusers are especially at risk.
Overdosage
Symptoms
Nausea; vomiting; drowsiness; confusion; liver tenderness; low or high BP; cardiac arrhythmias; jaundice; acute hepatic and renal failure.
Patient Information
- Instruct patient to take drug at first sign of impending headache.
- Encourage patient to rest in quiet, dark room after taking drug.
- Advise patient not to drink alcoholic beverages.
- Instruct patient to notify health care provider of dizziness or skin rash.
- Instruct patient to notify health care provider if headache persists.
Copyright © 2009 Wolters Kluwer Health.
