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Pizotifen to prevent migraine headaches
Pizotifen to prevent migraine headaches
This leaflet is about the use of pizotifen to prevent migraine headaches. This is sometimes called migraine prophylaxis. It will not help a migraine headache that has already started.
This leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Do not stop giving pizotifen suddenly as your child may get withdrawal symptoms.
Name of drug
Brand name: Sanomigran®
Why is it important for my child to take this medicine?
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.
It is important that you follow your doctor’s instructions about how much to give.
How should I give it?
Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet.
Liquid medicine: Measure out the right amount using a medicine spoon or oral syringe. 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 fully and your child may continue to have some migraine headaches during this time. It is important that you continue to give pizotifen as your doctor has told you to.
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, you do not need to give them another dose. Wait until the next normal dose.
If your child is sick again, seek advice from your GP, 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 7 am, you can give the missed dose at any time up to 11 am. If you remember after that time, do not give the missed dose. Wait until the next normal dose.
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: If you miss a dose, wait until the next normal dose. Do not give the missed dose.
Never give a double dose of pizotifen.
What if I give too much?
It may dangerous to give too much pizotifen.
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 (111 in England and Scotland; 0845 4647 in Wales) or take your child to hospital. Take the medicine container or packet with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.
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 http://www.mhra.gov.uk/yellowcard.
Can other medicines be given at the same time?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Do not give your child other medicines that make them sleepy (e.g. antihistamines, and some common cold medications) at the same time as pizotifen.
- Pizotifen should not be taken with some common medicines that you get on prescription. Tell your doctor and pharmacist about any medicines your child is taking before starting pizotifen.
- Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines
Is there anything else I need to know about pizotifen?
Do not stop giving pizotifen suddenly, as your child may get withdrawal symptoms such as anxiety, tremors (shakiness), nausea and difficulty sleeping.
- 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.
Do not change the dose or how often you give pizotifen without talking to your doctor first.
- 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 by accident, contact your doctor for advice.
- Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where I should keep this medicine?
- Keep the medicines 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.
You can also get useful information from:
- England - NHS 111
- Scotland - NHS 24
- Wales/Galw lechyd Cymru - NHS Direct
0845 46 47
- Northern Ireland - NI Direct
- Migraine Action
0116 275 8317
- Migraine Adventure (8-10 years)
- Migraine Explorers (11-13 years)
- Migraine Network (14-17 years)
- Migraine Trust
020 7631 6970
Version 2, July 2014. © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed 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.