Amidrine

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Amidrine, Duradrin, Epidrine, Nodolor or Midrin, is a combination of acetaminophen, dichloralphenazone, and isometheptene[1][2] used mostly to treat headaches.

Components[edit]

  • Paracetamol (acetaminophen) is a common over-the-counter pain reliever and fever reducer.
  • Dichloralphenazone is a mild sedative owing primarily to its hydrolysis product, chloral hydrate. Chloral hydrate, a schedule C-IV controlled substance, is a sedative/hypnotic drug that acts on the central nervous system to produce relaxation and decrease emotional stimuli that influence the perception of pain associated with headache.
  • Isometheptene is a vasoconstrictor, a drug that causes constriction (narrowing) of cerebral blood vessels.

The pathophysiology of vascular headaches, especially migraine, is thought to be related to dilation of these cerebral blood vessels, so drugs that act to constrict them are used in the treatment of these problems.

Common application[edit]

This drug is commonly used in the treatment of migraine headaches and is currently available in the United States and United Kingdom by prescription only.

One study has shown that this drug may work better than Imitrex for treating migraines.[3]

Availibility[edit]

Midrin was discontinued by Caraco Pharmaceuticals as of 2009.[citation needed]Due to an FDA seizure of 33 drugs manufactured by Caraco Pharmaceuticals due to cGMP (Current Good Manufacturing Practices)violations.[4] Generic forms of midrine were also discontinued due to loss of FDA grandfather approval status. Manufacturers felt it was not financially prudent to perform FDA testing. The discontinued generic forms are: Amidrine (Actavis), Duradrin (Barr), I.D.A (Teva), Migquin (Qualitest), Migrin-A (Prasco)and Migrazone (Breckenridge).[5] However, it is being manufactured again by Macoven Pharmaceuticals and marketed under the name Nodolor as of April, 2014. It can also be obtained through a compounding pharmacy with a doctor's prescription.

References[edit]

  1. ^ Meschia JF, Malkoff MD, Biller J (May 1998). "Reversible segmental cerebral arterial vasospasm and cerebral infarction: possible association with excessive use of sumatriptan and Midrin". Arch. Neurol. 55 (5): 712–4. doi:10.1001/archneur.55.5.712. PMID 9605729. 
  2. ^ Johnston JC (November 2009). "Life threatening intracerebral hemorrhage with isometheptene mucate, dichlorophenazine and acetaminophen combination therapy". J Forensic Leg Med 16 (8): 489–91. doi:10.1016/j.jflm.2009.07.006. PMID 19782324. 
  3. ^ Freitag, F. G.; Cady, R; Diserio, F; Elkind, A; Gallagher, R. M.; Goldstein, J; Klapper, J. A.; Rapoport, A. M.; Sadowsky, C; Saper, J. R.; Smith, T. R. (2001). "Comparative study of a combination of isometheptene mucate, dichloralphenazone with acetaminophen and sumatriptan succinate in the treatment of migraine". Headache 41 (4): 391–8. doi:10.1046/j.1526-4610.2001.111006391.x. PMID 11318886. 
  4. ^ "Questions and Answers: Seizure of Drug Products Manufactured by Caraco Pharmaceutical Laboratories Ltd.". 
  5. ^ "Drug Profiles: MIDRIN®".