Pizotifen
Indications
Pizotifen is used for:
Headache, Migraine
Adult Dose
Oral
Prophylaxis of migraine; Prophylaxis of cluster headache
Adult: Initially, 0.5 mg, increase gradually as necessary.
Maintenance: 1.5 mg daily as a single dose at night or in 3 divided doses.
Max: 4.5 mg daily (max <3 mg/dose).
Hepatic impairment: Dose adjustment may be needed.
Child Dose
Oral
Prophylaxis of migraine; Prophylaxis of cluster headache
Child: >2 yr Initially, 0.5 mg. May increase gradually up to 1.5 mg daily in divided doses (max 1 mg/dose).
Renal Dose
Renal impairment: Dose adjustment may be needed.
Administration
May be taken with or without food.
Contra Indications
Premature infants or neonates. Postural giddiness.
Precautions
Patient w/ angle-closure glaucoma, urinary retention, epilepsy. Avoid abrupt withdrawal. Renal and hepatic impairment. Childn. Pregnancy and lactation. Patient Counselling This drug may cause drowsiness, somnolence and dizziness, if affected, do not drive or operate machinery. Monitoring Parameters Monitor hepatic function (prolonged use), wt gain, BP.
Pregnancy-Lactation
Interactions
Enhances sedative effects of CNS depressants. Additive antimuscarinic action with other antimuscarinic drugs. May mask warning signs of damage caused by ototoxic drugs eg, aminoglycosides.
Adverse Effects
Side effects of Pizotifen :
Increased appetite, nausea, wt gain, drowsiness, dizziness, dry mouth, fatigue, muscle pain or cramps, heavy or restless legs, fluid retention, facial flushing, reduced libido, exacerbation of epilepsy, dreaming, hepatic injury.
Mechanism of Action
Pizotifen is a sedating antihistamine with strong serotonin antagonist and weak antimuscarinic properties. It also antagonises the action of tryptamine.