📋 Indications & Clinical Dosage
*Treatment of acute migraine with or without aura:*
Adult: 40 mg, followed by 40 mg after 2 hours only if migraine recurs, patient not responding to initial dose should not take second dose for same attack, increased if necessary to 80 mg, dose to be taken for subsequent attacks if 40 mg dose inadequate; max. 80 mg per day.
⛔ Contraindications
Arrhythmias, coronary vasospasm, heart failure, ischaemic heart disease, peripheral vascular disease, previous cerebrovascular accident, previous myocardial infarction, previous transient ischaemic attack, Prinzmetals angina, severe hypertension, uncontrolled hypertension
⚠️ Precautions & Warnings
Predisposition to coronary artery disease, elderly, history of seizures, mild controlled hypertension, pre-existing cardiac disease, risk factors for seizures, renal or hepatic impairment (reduce dose), Avoid in severe impairment. In renal impairment reduce initial dose to 20 mg; maximum 40mg in 24 hours.
🔄 Drug Interactions
Methysergide, ergotamine or its derivatives, other triptans or 5HT1-agonist, potent CYP3A4 inhibitors, protease inhibitors St. Johns Wort.
⚠️ Adverse Reactions / Side Effects
Agitation, anorexia, abdominal pain, chills, dizziness, drowsiness, dry mouth, dyspepsia, fatigue, headache, myalgia, myasthenia, palpitation, pharyngitis, rhinitis, sweating, tachycardia, arthralgia, confusion, depression, diarrhoea, dysarthria, dyspnoea, euphoria, glossitis, hypertonia, insomnia, movement disorders, oedema, photophobia, pruritus, taste disturbance, thirst, tinnitus, tremor, urinary frequency, visual disturbances
Rare: Asthma, bradycardia, constipation, lymphadenopathy, menorrhagia, oesophagitis, syncope, ischaemic colitis