Nomigren, 10 pcs.

Nomigren is a combination drug, it has antimigraine, antispasmodic and analgesic effects.

Ergotamine is an ergot alkaloid, a partial agonist of serotonin receptors, non-selectively blocks 5-HT1A-1D receptors. Ergotamine is characterized by alpha-adrenoblocking activity in combination with a pronounced direct vasoconstrictor effect on the smooth muscle of peripheral and cerebral vessels.

In this regard, against the background of ergotamine action the tonic effect on peripheral and cerebral vessels prevails, which is of therapeutic importance in relieving migraine attacks.

Propiphenazone has analgesic effects.

Caffeine accelerates absorption of ergotamine and increases its therapeutic effect. Caffeine also has a tonic effect on the cerebral vessels.

Camilofin has an antispasmodic effect, eliminating the initial vasospasm in the prodromal phase of a migraine attack.

Mecloxamine has anticholinergic, antihistamine, moderate sedative and antiemetic effects.

Pharmacokinetics

Ergotamine is slightly absorbed from the gastrointestinal tract after oral administration.

The bioavailability is low due to intense metabolism during primary passage through the liver.

The main metabolites are excreted through the intestine with bile. About 4% is excreted unchanged by the kidneys. Excretion of ergotamine is biphasic. T_1/2 in the final phase is 21 hours.

Caffeine is well absorbed in the intestine (including the colon). T_1/2 is about 5 h. About 10% is excreted unchanged by the kidneys.

After oral administration, about 25% of propifenazone is metabolized by primary passage through the liver, V_d is 0.4 L/kg, C_max in plasma is reached within 30-40 min, maximum effect in 90 min, T_1/2 is 2.1-2.4 h, excreted by the kidneys.

The T_1/2 of mecloxamine and camilofin is 1.5-2 h, excreted by the kidneys.

Indications

Active ingredient

Composition

1 coated tablet contains:

The active ingredients

Excipients

Corn starch,

Lactose monohydrate,

Crosspovidone,

talc,

magnesium stearate,

gelatin,

colloidal silicon dioxide,

tartaric acid,

red iron oxide dye,

titanium dioxide,

p> macrogol 6000,

polyacrylate dispersion,

polysorbate 80,

sodium carmellose.

How to take, the dosage

Ingestion with water.

Nomigren should be taken at the beginning of an attack. The recommended dose for the first dose is 1-2 tablets; if there is no improvement after 30 minutes, take 1-2 more tablets. The maximum daily dose is not more than 4 tablets; the maximum dose for 1 week is not more than 10 tablets.

The drug is not recommended for long term use: after 7 days of use, if longer treatment is needed, take a 3-4 day break.

Interaction

The drug should not be administered concomitantly with vasoconstrictors since this may lead to life-threatening arterial hypertension. Concomitant use with serotonin agonists (including sumatriptan) increases the risk of prolonged vasospastic reactions.

Concomitant use with antibiotics of the macrolide group (including erythromycin) may increase plasma concentrations of ergotamine.

Amantadine, quinidine and tricyclic antidepressants potentiate the drug.

Nomigren increases the effect of ethanol and sedatives.

Alpha-adrenergic stimulants, beta-adrenoblockers and nicotine increase the vasoconstrictor effect of the drug.

Special Instructions

Do not use the drug to prevent a migraine attack!

Patients taking Nomigren should have their blood count checked periodically.

When taking ergotamine-containing drugs systematically, the patient should be warned about the need to strictly adhere to the prescribed doses to avoid the development of ergotism: Peripheral vascular spasm – loss of sensation, paresthesias, tingling sensation in the extremities, pain in the lower extremities, cyanosis (especially in the fingers), marked decrease in pulsation, and CNS disorders – dizziness, stupor, coma, seizures.

If symptoms such as numbness of the tips of the fingers or toes, pain in the heart region, acceleration or deceleration of heart rate occur, the drug should be stopped immediately and a physician should be consulted.

Impact on the ability to drive vehicles and other mechanisms.

The drug may affect the psychophysical abilities of the patient, especially when concomitantly taken with alcohol or CNS depressant drugs. It is prohibited to drive vehicles and operate potentially dangerous mechanisms for 2-3 hours after taking the drug Nomigren.

Contraindications

Side effects

CNS disorders: sleep disturbances, increased excitability; with long-term use it is possible to develop addiction.

System disorders: transient tachycardia, ECG changes, increased BP, heart pain, bradycardia, muscle pain, decreased pulsation in extremities, paresthesias in extremities (most of these effects are associated with increased peripheral vascular tone).

Digestive system disorders: nausea, vomiting; rarely – diarrhea.

Others: weakness in the legs; rarely – peripheral edema, itching of the skin.

Overdose

Symptoms:Nausea, vomiting, general weakness, paresthesias, tinnitus, pain and cyanosis of the lower extremities (with decreased or complete absence of pulsation in the peripheral arteries), high or low blood pressure, tachycardia, sleepiness, stupor, seizures, anxiety.

Treatment: Gastric lavage, if not more than 4 hours after taking the drug, administration of activated charcoal, if necessary – symptomatic therapy.

Pregnancy use

The use of Nomigren is contraindicated in pregnancy (due to its uterine stimulation effect).

Lactation

The use of the drug during lactation is not recommended because ergotamine and caffeine penetrate into the breast milk in sufficient quantities (there is a risk of ergotism in the baby).

If it is necessary to use the drug during lactation, breastfeeding should be stopped.

Perinent use in children

It is contraindicated in children and adolescents under 15 years of age.