Pizotifen for migraine headaches

Name of medicine

Pizotifen

Brand name: Sanomigran

Why is it important for my child to take Pizotifen?

Migraine headaches are thought to be caused by the effects of certain chemicals in the brain’s blood vessels. Pizotifen stops these effects, so your child should have fewer migraine headaches. Any headaches they do get will be less intense. Pizotifen must be taken regularly to prevent migraine headaches. Pizotifen will not stop a migraine attack that has already started.

What is Pizotifen available as?

• Tablets: 500 micrograms, 1.5 mg; these contain lactose
• Liquid medicine: 250 micrograms in 5 mL; this may contain alcohol

When should I give Pizotifen

You will start by giving pizotifen once each day, which is usually in the evening.

Your doctor may later tell you to give pizotifen to your child twice or three times a day.

• For twice a day: this should be first thing in the morning and at bedtime. Ideally these times should be about 12 hours apart.
• For three times a day: this should be first thing in the morning, early afternoon (or immediately after school) and at bedtime. Ideally, these times are at least 4 hours apart.

Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of Pizotifen (the dose) that is right for your child. The dose will be shown on the medicine label.

How should I give Pizotifen?

Tablets

• Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablet.

Liquid medicine

• Shake the medicine well.
• Measure out the right amount using an oral syringe or a medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

When should the medicine start working?

It may take a few weeks for Pizotifen to work properly, so your child may still have their symptoms for a while. Continue to give the medicine as you have been told to by your doctor.

What if my child is sick (vomits)?

• If your child is sick less than 30 minutes after having a dose of Pizotifen, give them the same dose again.
• If your child is sick more than 30 minutes after having a dose of Pizotifen, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it?

If you usually give it once a day: Give the missed dose in the morning. If you remember after this, do not give the missed dose. Give the next bedtime dose as usual.

If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7am, you can give the missed dose at any time up to 11am. If you remember after that time, do not give the missed dose. Give the next dose as usual.

If you forget to give the bedtime dose, you do not need to wake up a sleeping child to give the missed dose. Just give the next dose as usual.

If you usually give it three times a day: Do not give the missed dose. Just give the next dose as usual.

What if I give too much?

It can cause drowsiness (feeling sleepy), dizziness, dryness of the mouth, confusion, excitation, unsteadiness, nausea, vomiting, breathing difficulties and seizures (fits).

If you think you may have given your child too much Pizotifen, contact your doctor or local NHS services (details at end of leaflet) or take your child to hospital. Have the medicine container or packaging with you, even if it is empty. This will be useful to the doctor.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects). Most of these side-effects should wear off as your child’s body gets used to the medicine. If they are still a problem after about 2 weeks, contact your doctor.

• Your child may feel drowsy (sleepy). This is helped by giving pizotifen at night. If your child also takes pizotifen during the day, remember that they may not be alert. Care needs to be taken with activities that may put your child (or other children) at risk. Tell your child’s teacher that they may be drowsy.
• Your child may be more hungry than usual (increased appetite). Encourage them to eat fruit and vegetables and low-calorie foods, rather than foods that contain a lot of calories (avoid crisps, cakes, biscuits and sweets), and to have plenty of exercise. Otherwise they may put on weight.
• Your child may have a dry mouth. Eating citrus fruits (e.g. oranges) and taking sips of water may help.
• Your child may feel sick (nausea).
• Your child may have constipation (difficulty doing a poo), lethargy (feeling physically tired) or pain in the muscles and joints. Rarely, your child may have seizures (fits) or jaundice (the skin or eyes look yellow). Contact your doctor if your child has any of these symptoms.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at mhra.gov.uk/yellowcard

Can other medicines be given at the same time as Pizotifen?

• You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

• Pizotifen can make your child sleepy, so do not give your child any other drugs that also have this effect, such as some medicines for hay fever.

• Pizotifen should not be taken with some medicines. Tell your doctor or pharmacist about any other medicines your child is taking before giving Pizotifen.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

• If you or your doctor wants to stop pizotifen, you will need to discuss the best way to reduce the dosage so that your child does not get withdrawal symptoms.
• Pizotifen, when taken regularly, helps stop migraine attacks from beginning. Do not give it to your child to get rid of a migraine attack that has already started – it will not help.
• Try to avoid known triggers that bring on migraine attacks (certain foods, stress, lack of sleep).

General advice about medicines

• Try to give medicines at about the same times each day, to help you remember.

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• If you think someone else may have taken the medicine, contact a doctor straight away.

• Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight.

• It does not need to be kept in the fridge.

• Keep the medicine in the container it came in.

• Make sure that children cannot see or reach the medicine.

Who to contact for more information?

Your child’s doctor and pharmacist will be able to give you more information about Pizotifen and about other medicines used to treat or prevent migraine headaches.

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by July 2017.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.