Monday, 23 July 2012

Migard






Migard 2.5 mg film-coated tablets


Frovatriptan



Read all of this leaflet carefully before you start taking this medicine.


  • Keep this leaflet. You may need to read it again.

  • If you have any further questions, ask your doctor or pharmacist.

  • This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

  • If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.



In this leaflet:


  • 1. What Migard is and what it is used for

  • 2. Before you take Migard

  • 3. How to take Migard

  • 4. Possible side effects

  • 5. How to store Migard

  • 6. Further information




What Migard Is And What It Is Used For


Migard 2.5 mg tablets contain frovatriptan, an anti-migraine treatment belonging to the class of triptans (5-hydroxytryptamine (5HT1) selective receptor agonists).


Migard 2.5 mg tablets is a medicine for the treatment of the headache phase of a migraine attack with or without aura (a temporary strange feeling before a migraine, which varies from person to person but can affect, for example, vision, smell, hearing).


Migard 2.5 mg tablets should not be used to prevent a migraine attack.




Before You Take Migard


The diagnosis of migraine must have been clearly established by your doctor



Do not take Migard


  • If you are allergic (hypersensitive) to frovatriptan or any of the other ingredients of Migard 2.5 mg tablets.

  • if you have had a heart attack, or suffer or have suffered from certain cardiovascular diseases such as angina pectoris (characterised by crushing pain in the chest which can extend into the left arm), or circulation disorders of the legs or arms (especially in the fingers and toes),

  • if you have had a stroke or a transient ischaemic attack (TIA),

  • if you have severely or moderately high blood pressure, or if your blood pressure is not adequately controlled,

  • if you have severe liver disease,

  • in combination with certain other medicines also used in the treatment of migraine (ergotamine and ergotamine derivatives (including methysergide) or other triptans (5-hydroxytryptamine (5HT1) agonists).



Take special care with Migard


  • if you are a patient at risk of coronary artery disease, including if:

> you are a heavy smoker or a user of nicotine substitution therapy


> you are a post-menopausal female or a male aged over 40 years


In any of these cases ask for your doctor’s advice before taking Migard.


In very rare cases a feeling of tightness or pain in the chest can occur when taking triptans, even in patients with no history of cardio-vascular disease. If this occurs contact your doctor and do not take an additional dose of this medicine.




Using other medicines


Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.


You should not take this medicine at the same time as certain other medicines used for the treatment of migraine:


  • especially ergotamine, ergotamine derivatives (including methysergide); you should allow at least 24 hours to elapse between the discontinuation of these medicines and the administration of Migard 2.5 mg tablets. Similarly, you should not take these medicines within 24 hours following a dose of Migard 2.5 mg tablets.

  • especially other triptans (5-HT1 agonists, such as sumatriptan, almotriptan, eletriptan, naratriptan, rizatriptan or zolmitriptan).

Unless otherwise directed by your doctor, you should not take this medicine at the same time as monoamine oxidase inhibitor (MAOI) medicines used in the treatment of depression (phenelzine, isocarboxazid, tranylcypromine, moclobemide).


  • you should also tell your doctor or pharmacist if you are taking oral contraceptives or selective serotonin-reuptake inhibitors (citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline).

It is recommended that you do not take Migard 2.5 mg tablets at the same time as taking St. John's Wort (hypericum perforatum).


Concomitant use of Migard with the medicines listed above (especially monoamine oxidase inhibitors, selective serotonin-reuptake inhibitors and hypericum perforatum) may also increase the risk of serotonin syndrome (the symptoms of serotonin syndrome include: shivering, sweating, agitation, trembling and abrubt contraction of muscles, nausea, fever, confusion).


If you have any doubt about taking other medicines with Migard 2.5 mg tablets, consult your doctor or pharmacist.




Taking Migard with food and drink


Migard 2.5 mg tablets can be taken with food or on an empty stomach, always with an adequate amount of water.




Pregnancy and breast-feeding


Ask your doctor or pharmacist for advice before taking any medicine.


Migard 2.5 mg tablets should not be used during pregnancy or when breast feeding, unless you are told so by your doctor. In any case, you should not breastfeed for 24 hours after taking Migard and during this time any breast milk expressed should be discarded.




Driving and using machines


Migard 2.5 mg tablets and the migraine itself can cause drowsiness. If affected, driving or operating machinery can be dangerous and should be avoided.




Important information about some of the ingredients of Migard


This product contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.





How To Take Migard


Always take Migard 2.5 mg tablets exactly as your doctor has told you. You should check with your doctor if you are not sure.


Take Migard 2.5 mg tablets as early as possible after the onset of the migraine headache. Swallow one tablet whole with water.


If the first dose does not give you any relief, do not take a second dose during the same attack. You can use Migard 2.5 mg tablet for any following attacks.


If you obtain relief after the first dose, but later on suffer from the re-appearance of a headache within 24 hours, you can take a second dose provided that at least 2 hours have elapsed between the 2 doses.


Do not exceed the maximum dose of 5 mg (two tablets) in 24 hours.


Excessive use (repeated use over several consecutive days) of Migard 2.5 mg tablets constitutes incorrect use of this medicine and may cause an increase in side effects and lead to chronic daily headaches requiring the temporary discontinuation of treatment. Consult your doctor if you start having too frequent or daily headaches as you may be suffering from medication overuse headache.


Migard should not be used in patients under 18 years of age.


As there is little experience in patients over 65 years, the use of Migard is not recommended in patients in this age group.



If you take more Migard than you should


If you accidentally take an overdose of this medicine, tell your doctor or pharmacist immediately or go to the emergency department of your nearest hospital. Please remember to take the remaining tablets or this leaflet with you.




If you stop taking Migard


No special precautions are necessary when stopping the drug.



If you have any further questions on the use of this product, ask your doctor or pharmacist.




Migard Side Effects


Like all medicines, Migard 2.5 mg tablets can cause side effects, although not everybody gets them.


A feeling of tightness or pains in the chest, sometimes intense and potentially extending to the throat, can occur within minutes of taking the medicine; if this occurs contact your doctor and do not take an additional dose of this medicine.


The side-effects reported during clinical studies with Migard 2.5 mg tablets were temporary, generally mild to moderate and disappeared spontaneously. Some symptoms reported may be caused by the migraine itself.


The following side-effects were commonly observed (estimated frequency is more than 1 person out of 100 and less than 1 person out of 10):


  • nausea (feeling sick), dry mouth, digestion problems, stomach pain,

  • fatigue, chest discomfort (sensation of slight heaviness, pressure or tightness in the chest),

  • headache, dizziness, sensation of pins and needles, most frequently in the arms and legs, reduction or exaggeration of the sensations of touch, extreme sleepiness,

  • hot flushes,

  • tightness in the throat,

  • sight disturbances,

  • increased sweating.

The following were uncommonly observed (estimated frequency is more than 1 person out of 1000 and less than 1 person out of 100):


  • altered sense of taste, trembling, poor concentration, lethargy, increased sensation of touch, drowsiness, involuntary muscle contractions,

  • diarrhoea, difficulty in swallowing, gas in stomach or bowel, stomach discomfort, bloated stomach,

  • awareness of heart beat (palpitations), fast heart beat, increased blood pressure, chest pain (intense tightness or feeling of pressure in the chest),

  • feeling hot, reduced tolerance of heat and cold, pain, weakness, fever, thirst, sluggishness, increased energy, generally feeling unwell, foggy head or lightheadedness, sensation of spinning,

  • anxiety, inability to sleep, confusion, nervousness, agitation, depression, loss of sense of personal identity,

  • coldness in the hands and feet,

  • irritation of the nose, inflamed sinus, sore throat and/or voice box,

  • muscle stiffness, muscle and joint pain, pain in the hands and feet, back pain, painful joints,

  • eye pain, eye irritation, painful oversensitivity to light,

  • itchiness,

  • ringing in the ears, earache,

  • dehydration,

  • passing urine frequently, production of large amounts of urine.

  • high blood pressure.

The following were rare (estimated frequency is more than 1 person out of 10,000 and less than 1 person out of 1000):


  • muscle spasm, floppy muscles, diminution of reflexes (hyporeflexia), movement problems,

  • constipation, burping, heartburn, irritable bowel syndrome, lip blisters, lip pain, spasm of the gullet, blisters in the mouth, ulcer in the stomach or upper part of the small intestine, pain in the salivary gland, inflammation of the mouth, toothache,

  • fever

  • loss of memory, abnormal dreams, personality disorder,

  • nosebleed, hiccups, overbreathing, breathing disorder, sore throat,

  • night blindness,

  • skin reddening, sensation of hairs standing on end, purplish spots or patches on skin and mucous surfaces of the body, hives,

  • slow heart beat,

  • ear discomfort, earache, ear itchiness, sensitive hearing,

  • increase in bilirubin (a substance produced by the liver) in the blood, decrease of calcium in the blood, abnormal urine analysis,

  • low sugar in the blood,

  • passing urine frequently at night, pain in the kidneys,

  • self-inflicted injury (eg bite or bruising),

  • swollen lymph nodes,

  • breast pain or discomfort.

There have been a very few cases of allergic reactions to Migard, with skin rash and sometimes serious whole-body allergic-type reactions (anaphylaxis), with possible sudden difficulty in breathing, fast heart beat and palpitations. If this occurs, get medical help immediately.


If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.




How To Store Migard


Do not use Migard 2.5 mg tablets after the expiry date which is stated on the carton. The expiry date refers to the last day of that month.


Do not store above 30°C.


Blister: store in the original package.


Bottle: keep the container tightly closed.


Keep out of the reach and sight of children.


Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.




Further Information



What Migard contains


The active substance is 2.5 mg of frovatriptan as succinate monohydrate per tablet.


The other ingredients are: anhydrous lactose, microcrystalline cellulose, magnesium stearate, sodium starch glycollate (type A), silica colloidal anhydrous. Film coating: OPADRY white: titanium dioxide (E171), anhydrous lactose, hypromellose (E464), macrogol 3000, triacetin.




What Migard looks like and contents of the pack


Migard 2.5 mg tablets are available in the form of round film-coated tablets, debossed with "m" on one side and "2.5" on the other.


Each blister pack contains 1, 2, 3, 4, 6 or 12 tablets.


Each child-proof bottle contains 30 tablets.


Not all pack sizes may be marketed.




Marketing Authorisation Holder and Manufacturer



Marketing Authorisation Holder:



Menarini International Operations Luxembourg S.A.

1, Avenue de la Gare

L-1611

Luxembourg



Manufacturer:



Almac Pharma Services Limited

Almac House

20 Seagoe Industrial Estate

Craigavon – County Armagh

Northern Ireland

BT63 5UA

United Kingdom


or



Berlin-Chemie AG

Glienicker Weg 125 – D-12489 Berlin

Germany


or



A.Menarini Manufacturing Logistics and services s.r.l.

Via Campo di Pile – L’Aquila (AQ)

Italy


or



Laboratorios Menarini S.A.

Alfonso XII

587, E-08918 Badalona (Barcelona)

Spain



This medicinal product is authorised in the Member States of the EEA under the following names:


France (RMS) : Isimig


Austria : Eumitan


Belgium : Migard


Czech Republic : Recur


Estonia : Migard


Denmark : Migard


Finland : Migard


Germany : Migard


Greece : Pitunal


Hungary : Migard


Iceland : Migard


Ireland : Miguar


Italy : Rilamig


Latvia : Migard


Lithuania : Migard


Luxembourg : Migard


Norway : Migard


Poland : Migard


Portugal : Migard


Slovakia : Migard


Slovenia : Migard


Spain : Forvey


Sweden : Migard


The Netherlands : Migard


United Kingdom : Migard




This leaflet was last approved in June 2009.


Frovatriptan developed by Vernalis Ltd





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