Migracid Tablet
Each tablet contains:
Paracetamol 500 mg .
Metoclopramide HCl 5 mg .
Company Name
CID
Therapeutic Group
ALL OTH A-MIGRAINE PREPS
Pharmaceutical form
Tablet
Package
Carton Box containing 2 strips each of 10 tablets.
Indications
- Migraine.
- Vomiting and nausea associated with migraine.
Warning & Precautions
* Caution is required in the following cases: - Sever hepatic and renal impairment. -Young patient and elderly as they are at increased risk of extrapyramidal reactions. - patients with history of atopy ( including asthma) or porphyria. - If vomiting persists the patient should be re-assessed to exclude the possibility of an underlying disorder , e.g cerebral irritation . *The ability to drive vehicles or operate machinery can be impaired, particularly if administered with CNS depressants or alcohol. Pregnancy & lactation: * Migracid should only be used during pregnancy when there are compelling reasons and like all drugs avoid use in the first and second trimester unless the physician believes the benefits outweigh the risk. Thereafter, patients should follow the advice of their doctor regarding its use. * During lactation, metoclopramide and paracetamol are excreted in breast milk and adverse reactions in the breast-fed baby cannot be excluded. A decision should be made whether to discontinue breast-feeding or to abstain from migracid treatment.
Product Type
human
Dosage
The total daily dosage of metoclopramide, especially for adolescent and young adult ,should not normally exceed 0.5 mg/ kg body weight.
• Maximum dosage in any 24 hours period for young adults (12-19 years): 2 tablets.
• Maximum dosage in any 24 hours period for adults: 3 tablets.
Adverse Reactions
* Nervous system and psychiatric disorders:
- Extra pyramidal symptom including (acute dystonia and akathisia ) may occur especially in children and young adults .
- Drowsiness, restlessness and depression may occur .
*GIT disorders: diarrhea may occur.
* Blood and lymphatic system disorders:
Blood dyscrasias including thrombocytopenia and agranulocytosis. * Endocrin disorders:
Hyperprolactinemia with amenorrhea , galactorrhea and gynaecomastia .
*Cardiac and vascular disorders:
Hypotension or Bradycardia may occur.
*Hypersensitivity and skin rashes may occur.
Contra Indications
-Gastrointestinal obstruction, perforation or hemorrhage .
- should be not be used in the immediate post-operative period (up to 3-4 days) following
pyloroplasty or gut anastomosis, as vigorous gastro-intestinal contractions may adversely
affect healing.
-Pheochromocytoma.
-Hypersensitivity to drug components.
-History of neuroleptic or metoclopramide-induced tarvide dyskinesia .
-Confirmed epilepsy .
Drug Interactions
- Levodopa and metoclopramide have a mutual antagonism.
- Alcohol potentiates the sedative effect of metoclopramide.
- Paracetamol may potentiate the effects of alcohol.
- Paracetamol may increase the elimination half-life of chloramphenicol.
- Oral contraceptives may increase the rate of paracetamol clearance.
- The speed of absorption of paracetamol may be increased by metoclopramide.
- The speed of absorption of paracetamol may be reduced by colestyramine.
- The anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular use of paracetamol with increased risk of bleeding; occasional doses have no significant effect.
- Anticholinergics and morphine derivatives antagonise the effects of metoclopramide on the gastrointestinal motility.
- Combination of CNS depressants (morphine derivatives, hypnotics, anxiolytics, sedative H1antihistamines, sedative antidepressants, barbiturates, clonidine and related) withmetoclopramide may result in potentiation of sedative effects.
- Combination of antipsychotics with metoclopramide may result in potentiation of
extrapyramidal effects.
- Metoclopramide decrease gastric sbsorption of digoxin so the dose may be adjusted.
- Metoclopramide increase ciclosporin bioavailability so the dose may be adjusted and to avoid toxicity careful monitoring of ciclosporin plasma concentration is required.
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