Adult 18-65 yr Recommended dose: 2.5 mg single dose. If symptoms of migraine recur following an initial response, a 2nd dose may be taken w/ min 4-hr interval between the 2 doses. Max total dose: Two 2.5 mg tab in 24-hr period. Renal & hepatic impairment Max dose: 2.5 mg single dose in 24-hr period.
Hypersensitivity. Patients who had MI, ischaemic heart disease, Prinzmetal's angina, coronary vasospasm, peripheral vascular disease or those who have symptoms or signs consistent w/ ischaemic heart disease; w/ history of CVA or transient ischaemic attack (TIA). Patients w/ moderate, severe & uncontrolled HTN. Concomitant use w/ ergotamine derivatives or ergotamine (including methysergide) &/or any triptan (5-HT1) receptor agonists. Severe renal (CrCl <15 mL/min) & hepatic (Child-Pugh grade C) impairment.
Known hypersensitivity to sulphonamides. Not indicated for the management of hemiplegic, basilar or ophthalmoplegic migraine. Exclude other potentially serious neurological conditions before treating headaches in patients not previously diagnosed as migraineurs & in those who present w/ atypical symptoms; migraineurs may be at risk of certain cerebrovascular events (eg, CVA or TIA). Not to be given in patients w/ risk factors for ischaemic heart disease including heavy smokers or nicotine substitution therapy users w/o prior CV evaluation; postmenopausal women & males >40 yr w/ these risk factors. Transient symptoms including chest pain & tightness. Possible serotonin syndrome following concomitant use w/ triptans & SSRIs/serotonin noradrenaline reuptake inhibitors (SNRIs). Prolonged use. Concomitant use w/ St. John's wort. Not to be taken by patients w/ rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. Drowsiness may occur; patients performing skilled tasks (eg, driving or operating machinery). Renal & hepatic impairment. Pregnancy. Avoid breastfeeding for 24 hr after treatment. Not recommended for patients <18 yr. Elderly >65 yr.
Possible serotonin syndrome when used concomitantly w/ SSRIs/SNRIs. Contraindicated w/ ergotamine-containing prep or other triptan/5-HT1 receptor agonists due to increased risk of coronary vasospasm. Decreased total clearance by OCs. Increased total clearance by smoking.
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