acetaminophen/dichloralphenazone/isometheptene (Midrin, Isocom, Amidrine)
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Introduction
65 mg isometheptene mucate + 100 mg dichloraphenazone + 325 mg acetaminophen. DEA-controlled substance: class 4.
Indications
- tension headaches
- vascular (migraine) headaches
Contraindications
- glaucoma
- severe renal disease
- hypertension
- heart disease
- hepatic disease
- concurrent MAO inhibitor therapy
Dosage
- migraine:
- 2 tabs PO followed by 1/h until relief
- up to 5/12 hours, 8/day; 15/week; 40/month
- tension headache:
- 1-2 capsules every 4 hours
- max: 8/day; 15/week; 40/month
Pharmacokinetics
elimination: liver
Adverse effects
- transient dizziness
- rash
- drowsiness
- hepatic impairment with chronic use
- less GI distress than ergotamine
Drug interactions
- concurrent use of MAO inhibitor may result in hypertensive crisis
- drug interaction(s) of acetaminophen in combination with GLP1-agonist
- drug interaction(s) of acetaminophen in combination with phenylephrine
- drug interaction(s) of alcoholic beverage with acetaminophen
- drug interaction(s) of ethanol with acetaminophen
Mechanism of action
- isometheptene constricts dilated cranial & cerebral arterioles
- dichloralphenazone is a mild sedative
- acetaminophen is an analgesic
More general terms
Components
- acetaminophen (Tylenol, Paracematol, Panadol, Tempra, Datril, APAP, non-Aspirin)
- dichloralphenazone (Kloralfenazon)
- isometheptene
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 - not on National VA formulary
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998