For now it appears dichloralphenazone (1 of the 3 ingredients in Midrin) is no longer available and the noted replacements (Prodrin, Migraten) are not the same ingredients/doses. Be careful that your physician understands that there is more acetaminophen and isometheptene in Prodrin and that caffeine is the 3rd ingredient. For now I am prescribing Midrin minus the dichloralphenazone (same dose of the 2 available ingredients) and a compounding pharmacy is making it. If I find that some patients require the sedative component, I can always add a sedative ingredient to the mix. My goal is to expand the headache medication armamentarium to suit the individual, not narrow it. Good Luck.
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Teri, thanks for this update. The information is very important and
valuable to receive, even when it isn't what we were hoping to
hear.
It would seem that the FDA exists to be self-serving rather than
serve to use common sense and help the people of this
country.
It would seem that the pursuit of replicating the three ingredients
in Midrin might be worthy. I'm putting in some time and study
on this. Acetaminophen is available; caffeine can be obtained;
the third ingredient is the challenge.
On a side note: In your article, you wrote "Thus, Excellium has now
ceased production of Epidrin, and they have no plans to seek
approval or make Prodrin again in the future." Did you intend to
say 'Prodrin' here or 'Epidrin' ?
Thanks again. Your work is greatly appreciated.
Phred,
You're welcome.
I must admit that I don't fully agree with you about the FDA. Did you see the part of my post about the isometheptene mucate in these medications being a vasoconstrictor? Some of the doctors I've spoken with feel that they're no safer for patients with a history of or risk factors for stroke, heart attack, and other cardiovascular issues than the triptans or ergotamines are. But, since they've not been through the FDA approval process, there's no data on that point.
You're right. I meant to say Epidrin. Thanks for catching that. I've fixed it.
Teri
Oops. I didn't address your comments about "replicating" the three ingredients. Midrin and the equivalent medications don't have caffeine. They contain isometheptene mucate, dichloralphenazone, and acetaminophen. Only one of those ingredients is available over-the-counter, the acetaminophen. The other two are by prescription only, and they're not available as just the one ingredient.
Teri