Thursday, October 30, 2014
Sunday, December 05, 2010 Jan Davis, Community Member, asks

Q: Since Midrin and the generic form of Midrin (Isometh...)has been discontinued. What drug can be used as a replacement? Thank you.

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Answers (22)
Teri Robert, Health Guide
12/15/10 6:26pm

Jan,

 

Good question! I spent some time earlier this week corresponding with the FDA to see if any of the so-called generics were going to be available. The short answr is, "probably not." You can read their full response in Midrin for Migraine: What's Going On?

 

To the question of what can be used as replacements...

 

Midrin has been a dual purpose medication. It worked as a Migraine abortive for some people, and for others, it worked well for tension-type headache. Unfortunately, Midrin and the other isometheptene mucate / dichloralphenazone / acetaminophen compounds were unique. There is no equivalent replacement.

 

For Migraine abortives, there are several options:

 

There two main types of abortive medications left, triptans and ergotamines. The triptans are newer and prescribed more often. There are seven medications in the triptan family-- Imitrex, Maxalt, Zomig, Amerge, Relpax, Axert, and Frova -- as well as Treximet, which is a combination of Imitrex and Naproxen Sodium. Each of the triptans binds to different combinations of serotonin receptors, which is why our bodies may respond differently to each of them. It's well worth discussing the ones you haven't tried with your doctor.

 

If none of the triptans work well for you, you can also ask him about Migranal Nasal Spray or DHE injections that you can give yourself at home. There are a few other ergotamine medications, but Migranal and DHE are the most commonly prescribed.

 

The problem comes in if you have a history of or risk factors for stroke or other cardiovascular issues because the triptans and ergotamines are generally not recommended for patients with those issues. In some cases, doctors may make exceptions and prescribe them if they feel the risks of the Migraines are worse than the risks of the medications. Otherwise, doctors may prescribe NSAIDs, opioids, or other medications usually reserved for us as rescue medications when abortives fail.

 

The best thing to do is have a good discussion with your doctor about which of the remaining options are best for you.

 

I hope this gives you the information you need.

Teri

Reply
davebc15, Community Member
2/ 1/11 10:16am

Hi Teri,

 

I have tried the ergotamines (specifically Cafregot) and it was unsuccessful in treating my migraines.  I am also on an SSRI and am reluctant to take a triptan due to the potential of Serotonin Syndrome.  I was wondering where medications such as Fioricet and Fiorinal (which I have had relatives with migraines take with varying degrees of success), would fit in to the classification of migraine treatments.

 

Thanks!  Keep up the fight for all of us Migraineurs!

 

Dave

Reply
Teri Robert, Health Guide
2/ 1/11 10:54am

Hi, Dave,

 

Fioricet and Fiorinal are considered rescue medications to be used when abortives fail. They cannot stop a Migraine. All they can do is mask the pain for a few hours, and they don't help with other Migraine symptoms.

 

I understand your concern about serotonin syndrome, but please keep in mind that the prescribing information for triptans and SSRIs and SNRIs doesn't say that they shouldn't be taken together; it says that patients should know the symptoms of serotonin syndrome so they can report them to their doctors if they occur. You can find more on this in Antidepressants, Triptans, and Serotonin Syndrome. Of course, we all have to talk with our doctors and make our own decisions, but I've been using triptans and an SSRI or SNRI for at least 15 years now.

 

Hope this helps,

Teri

Reply
Julia Sue, Community Member
2/17/11 12:59pm

Hi everyone,

I, too, have been so distressed at no more Midrin. A compounding pharmacist told me he could not obtain the dichloralphenazone ingredient, but then asked his supplier, who suggested this combo, which he has heard is effective:

Acetaminophen 325 mg

Chloral Hydrate 100 mg

Isometheptene Mucate 65 mg

 

In my own searching, have also seen mention of MigraTen, which contains acetaminophen, caffeine, & isometheptene mucate.

 

Teri, would love to know what you, and others, think of these possibilities. Thanks for all you do!

Reply
Teri Robert, Health Guide
2/17/11 1:13pm

Julia Sue,

 

Chloral hydrate is a very old sedative medication. Some of the doctors I've spoken with say they'd never prescribe it.

 

I have found that Prodrin is still available. It also containes isometheptene mucate, acetaminophen, and caffeine.

 

This question and discussion started back in December. There's more current info on the site. Since it's been hard for people to keep up with, I've created a spot in the upper right section of our home page that always has a link to the most current information we have. Right now, the most current info is at http://www.healthcentral.com/migraine/c/123/131753/discontinued.

 

Teri

Reply
electricgreen, Community Member
3/31/11 4:21pm

I got my script filled by a componding pharmacy and they used the Chloral hydrate.  I didn't even know it until last night (I've had it since last month), they never told me they subbed it.  I can say for me it didn't work as well as the "old" generic version, and I originally got pretty wiped out when taking it, which I never had happen with the "old" version.  But, when searching Dichloralphenazone, I find it listing Chloral hydrate as an ingredient ("Dichloralphenazone is a 1:2 mixture of antipyrine with chloral hydrate" source, wikipedia).  I also saw it referenced elsewhere but I don't have a PDR to confirm. 

Reply
Beth, Community Member
9/26/12 12:02am

My doctor prescribes this combination for me instead of Midrin, and it works really well for me.  

Reply
AprilLyne, Community Member
3/ 7/11 4:34am

Hello,

I'm sorry I'm coming into this thread so late, but I have just recently run out of my Midrin and have just recently heard about the discontinuation of my miracle drug. I have a bit of a curveball to this same question. I was in the ER today for my Migraine and had the ER Dr. stumped. I cannot take Triptans or anything else that affects my serotonin receptors, and I am allergic to morphine products and its' derivatives. The only thing the ER Dr. could think of to do was give me a Torridol shot to help take the edge off and an anti-nausea medicine. About 8 hours later the Torridol is wearing off and the throbbing is beginning to come to full force once again. Aura's have not ceased. I suffer from a large variety of Migraine symptoms, ranging from severe head full head pain-throbbing-whooshing-pain increasing with movement, "ice pick" pain-usually behind one eye-left being most common, auras consisting of a blurred vision, tunnel vision, loss of depth perception and other perceptions issues, strobe lights, bright and sometimes colorful floaters and swirls?-it’s hard for me to describe it, moderate to severe vertigo, and neck pain and stiffness, are the most common. I rarely go more than a few days without an episode although with the use of Midrin it was typically less, and more often than not I would not treat a silent migraine with Midrin. Occasionally my Migraines are silent, but over the past few years severe pain has been more often than not. I take propranolol as a preventative, which does seem to typically at least reduce the severity, or so I believe, as well as meclizine for the vertigo. I also suffer from depression- untreated primarily due to the said serotonin issue above, and anxiety which Xanax is used to treat the worst episodes. Midrin was a Godsend, a miracle, the only thing that worked for me, and seemingly the only medicine available for my Migraine treatment.

My question is do you have any suggestions I could speak with my Dr. about that may work with all of my Migraine issues, or perhaps a combination. I live over two hours from the nearest Neurologist, and have yet to see one, although I believe it may be my only option now. The “diagnosis” I have received from my Dr. are Migraine with Aura, Silent/Aura Migraine, and Ocular Migraine, which after reading up on Migraines here; I understand I need a better/clearer diagnosis. I have been suffering from Migraines since I was eight years-old. After twenty years of pain and nearly a decade with my beloved Midrin and not it no longer being available, I don’t know how I am even going to function anymore. I’m scared, as anyone who has suffered a Migraine knows, they are debilitating. I’m a full time student and a single mother of three; I don’t have time to have a Migraine! Any suggestions are much appreciated!

Thank you!

Reply
cannier, Community Member
3/23/11 1:06pm

Hi, AprilLyne.  Did you read the rest of the answers to this question... specifically the one about going to a compounding pharmacy where they can make this combination or a very close equivalent?  I hope you find what you need.  I'm in the same boat, although my migraines are not as severe as yours.  Over the years, Midrin (or its generics) have been the only thing that is reliable.

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SueBlue, Community Member
3/25/11 9:02pm

I have been absolutely distraught for the past week after find out Midrin was discontinued.  This med has saved me from so much pain, misery and anxiety over many years and now just the thought of being without it leaves me very anxious about what the future holds for me.  My migraines are debiitating without this medication.  Has anyone tried Botox injections for migraine.  A friend of mine advised me that FDA has now approved this for migraines and said it has been very successful in all the trials. 

 

Reply
Dan, Community Member
4/13/11 3:51pm

I literaly feel your pain...looks like the only thing we can do is to join a support group.  The difference between you and me though is that I am a married dad of 3.

Girls I'm afraidWink

Reply
queenbeejo, Community Member
4/19/11 8:44am

I also contacted the FDA and they gave me an answer but.... no go... I will post their reply.  Relpax was the only other thing that worked but you get so little of that per month.

 

Hello,

 

I just called Sandoz, on the number your provided,  and they said they are not manufacturing midrin or a "generic."  I know many people use this, as I have searched many headache forums and as with me, it is the only drug that works for them.  May I ask when they provided this information to you?

 

Thank you

 

JoLynn

 


From: CDER DRUG INFO [mailto:DRUGINFO@fda.hhs.gov]
Sent: Monday, April 18, 2011 1:43 PM
To: Jolynn
Subject: RE: Midrin

Dear JoLynn,

Thank you for writing to the Division of Drug Information in the FDA's Center for Drug Evaluation and Research.

FDA has not pulled Midrin from the market. I believe many manufacturers have ceased to make Midrin and its 'generic' versions. You may wish to have your pharmacist contact Sandoz (1-800-525-8747), as they have confirmed that they have product available. FDA has not asked manufacturers to discontinue manufacturing. However, please understand that Midrin has never been approved by FDA, and companies may have ceased manufacturing to comply with FDA regulations. You may find FDA enforcement actions against unapproved products at: http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/SelectedEnforcementActionsonUnapprovedDrugs/default.htm

Midrin is not FDA approved, but is on the Drug Efficacy Study Implementation (DESI) list. Since there is no approved application for Midrin, there are no approved generics for this product either. These products are not generics, but rather other products that contain the same ingredients as Midrin.

The following is a brief general history, relevant to Midrin:

In 1962, Congress amended the 1938 Food, Drug and Cosmetic Act to give the FDA the authority to regulate medicines on the basis of efficacy in addition to safety. That is, the amendment required manufacturers to show that their drug products were effective, as well as meeting the requirement of the earlier Act, that the products must be safe. As a result of the 1962 amendment, all the drugs approved under New Drug Applications (NDAs) between 1938 and 1962 had to be reviewed again for efficacy. Furthermore, for every drug initially sold between 1938 and 1962 with approval by FDA, five others were sold without FDA approval. Many of these drugs were chemically identical copies of previously approved drugs, and hence were known as "me-too" drugs. Many others were combinations of approved ingredients. FDA decided that the efficacy study, to be fair and to accomplish its purpose of improving therapeutics in the United States, had to apply as well to these non approved drugs. Because the resources of the FDA were too limited to do this, the agency asked the National Academy of Sciences/National Research Council (NAS/NRC) to assist in the review effort. The NAS/NRC chose 30 panels, each composed of six experts, to conduct the review of various categories of drugs. The manufacturers of drugs with NDAs that had been submitted between 1938 and 1962 were asked to submit to the FDA their evidence that the drug was effective. The NAS/NRC panels then reviewed the data. In late 1967, the panels began submitting their reports to the FDA. The FDA formed a task force to implement the recommendations in the reports. This was the Drug Efficacy Study Implementation (DESI) task force. DESI products can continue to be marketed until a final determination is made.

You may read about available treatments for various indications at: http://www.nlm.nih.gov/medlineplus/

I hope this information is helpful. I apologize for the problems that this issue is causing for you.

Best regards,
Drug Information RL
Division of Drug Information
Center for Drug Evaluation and Research
Food and Drug Administration

For up-to-date drug information, follow the FDA's Division of Drug Information on Twitter at FDA_Drug_Info

This communication is consistent with 21CFR10.85(k) and constitutes an informal communication that represents our best judgment at this time but does not constitute an advisory opinion, does not necessarily represent the formal position of the FDA, and does not bind or otherwise obligate or commit the agency to the views expressed.

 


From: Jolynn
Sent: Monday, April 18, 2011 1:06 PM
To: CDER DRUG INFO
Subject: Midrin

Hello,

 

Is there any update to the Midrin availability?  This is one of the only drugs that works for my tension/migraine headaches and I just tried to refill today and could not get any.  Any update is appreciated.

 

Thank you

 

JoLynn

 

 

Reply
pixiefairydust, Community Member
4/20/11 10:16am

Jolynn-

Have you tried contacting any Compounding Pharmacy's that do the Midrin?? Check around and see if they have a lab in there Pharmacy that makes the Midrin. My doctor gave me a prescription for Midrin and I found a Compounding Pharmacy that does the Midrin in there lab. I hope this helps you and someone else that reads.

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MissingMidrin, Community Member
4/25/11 3:48pm

Can you tell me if they are still making Prodrin?  it has two of the ingredients that Midrin does and I don't see where it has been discontinued - so I was hoping to try it.  Midrin is the only thing so far that helps my migraines - tried Maxalt - worthless, tried imitrex - didn't work even 1/2 as good as midrin.

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kathie, Community Member
1/11/12 3:02pm

you probably know already they do make Prodrin and I take it.  Works very well and is replacement for Midrin.  It is very costly though - through my insurance which I believe is pretty good it is $87.90 for 40 pills.  In this day and age that is pretty expensive.

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Teri Robert, Health Guide
1/11/12 3:34pm

Kathie,

 

Prodrin has now been discontinued also. We're keeping a link on our homepage with the most current information available. You can go directly to http://www.healthcentral.com/migraine/c/123/146239/midrin-medication/.

 

Teri

Reply
Wheels, Community Member
8/10/11 8:20am

Teri, have you seen this?  http://midrin.org/  Note the last paragraph at the bottom of the page.  Old page, factual, or too good to be true?

Reply
Teri Robert, Health Guide
8/10/11 10:58am

That's a very old page. Caraco will not be making or shipping Midrin again. None of the companies that were making similar drugs will be making them again. The only way to get a Midrin equivalent medication is through a compounding pharmacy.

 

Teri

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Miranda, Community Member
10/11/11 10:47pm

How many people would donate lots of money to a company who takes the effort to try to get Midrin approved by the FDA- and how outrageously rich would that company be when they were the ones manufacting Midrin - and a hero to migraine sufferers. I know I would... what's the holdup?

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butterfly18, Community Member
1/ 4/11 10:54am

since midrin has been discontinued what drug can be used as a replacement?

Reply
Teri Robert, Health Guide
1/ 4/11 2:45pm

butterfly,

 

Check out my reply directly above yours. I've answered this question there.

 

Teri

Reply
Barb, Community Member
3/16/11 10:54pm

I was also upset to hear that the wonderful Midrin was discontinued.  I saw one of the postings that said to go to a compounding pharmacy and they were able to make it for me. I picked it up today.  Before I left, though, the pharmacist said he was not able to get one of the ingredients anymore, but had found it at another pharmacy for my order today.  So, I recommend going immediately to a compounding pharmacy and getting them to make it immediately.  Several pharmacies that I called did have all of the ingredients currently on hand.  I got 100 pills and hope that buys some time until another medication that works for me can be found.

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yelloeyes, Community Member
3/25/11 5:36pm

Barb.. will you share the compounding pharmacy with us??  HOw much are they charging... I am getting desperate here.

 

I found 100 pills of epidrine at Target today and called my doctor to write me a scipt for them.. I got the last 20 from my Publix the other night.  The drug that everyone can't get is the dichloralphenazone.... and I found a compounder who bought a ton of it.... I am checking him out at the moment before I share.. he wants $1.50 a pill....

 

I have been taking this for over 15 years and I am sick to my stomach on this.. I can't take triptans and betas, etc.. nothing else has ever worked....

 

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Julia Sue, Community Member
3/25/11 6:46pm

Hi everyone, I have called compounding pharmacies here in the DC area, and so far can find no one who has access to dichloralphenazone...so...how does it work to fill a prescription  across state lines, if my prescription is written by a dr. in my state? I too have never found anything but Midrin would help me. Thanks!

 

Reply
Barb, Community Member
3/26/11 12:41am

Sure!  Glad to share!  I live in San Antonio, Texas and I found the two pharmacies that could make Midrin online along with a lot of other compounding pharmacies.  They are the only two I called, so there may be more that can make the Midrin for people.  The pharmacy I used was Alamo Heights Pharmacy (210-824-4561.)  I paid $85 for 100 pills.  They told me that they were not able to find anymore of that one ingredient, so I probably could not get them again there.  The other pharmacy that I did not use, but said they could make them (and had the ingredients on hand), was Broadway Pharmacy (210-824-3322.)  The quote the pharmacist gave me was $100 for 50 pills.  I would have paid it, but found the other pharmacy for less.  They are so scarce, I don't think that $2.00 a pill is too much.  If you do a search online for Broadway Pharmacy in San Antonio they have a website where you can send questions.  I imagine there are other pharmacies that might have websites, too.  I did a search for "compounding pharmacies" and "San Antonio" and "Texas" and that is how I came up with these two pharmacies.

 

A side note:  I discovered recently that I was getting migraines after eating canned corned beef hash (yes, I know a lot of people think it is awful, but I had a coupon.)  In January, I also got a migraine after eating corned beef hash.  I looked at the label and it is full of sodium nitrite and that is a big migraine trigger that I had no idea about.  Also, the migraine list I got online listed raisins and red wine, but didn't list red grapes, so I thought they were OK.  I found out that they are triggering headaches in me, so I thought I'd share that information in case anyone else might recognize that as a trigger for them, too. 

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E, Community Member
4/10/11 12:24am

Raisins, really?  No wonder I have so many migraines.  I don't get them from red wine though so discontinuing Raisin Bran for breakfast isn't going to help.  You'd think someone would make an over the counter version of Midrin; they can see we are desperate.  None of the Doc's substitues have worked for me so yes I would pay $2 a pill.

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Wheels, Community Member
4/11/11 8:29am

An OTC form of Midrin isn't going to happen.  It's a Class 4 drug (I think that's the right term) which means it is (or was) so highly controlled that a script can't be called in across state lines.  I was visiting family in MI during a rash of Migraines that made me run out of my travel supply of Midrin.  I visited a pharmacist about filling one of the refills that was in my pharmacy's system back in IA.  The pharmacist said they couldn't do that for Midrin and when my mother-in-law called to give them a piece of her mind, they elaborated that they could be imprisoned for filling that script.  If I really needed it, I'd need to see a Dr in MI.  I think that it's a medication that could be abused if someone was inclined to do so.

 

I'm going to try Prodrin.  The tripans only work half of the time for me, and I make my living on my creative thinking so the dulling effect that the preventatives have on my thinking ability makes them a nonstarter.  My Dr prescribed Fioricet (sp?) when Midrin suddenly fell off the map and it works okay if I can take it at onset, but it has zero impact when onset happens in my sleep and I wake up in the throws.  We'll see.

 

I'm a life-long Migraineur, now 35yrs old.  I have a list that's nearly a page long of meds that I've tried and Midrin is the only one that's reliable for me.  Even with Midrin, I've had a few Migraines in my lifetime when I've thought or said aloud -- with utmost sincerity -- something to the effect of, "If I died right now, I'd be okay with that."  Even being a father of two...   Now, I know that my Migraines pale in comparison to some other peoples', and I know that some of those other people rely on Midrin just like I have.  And I've heard and read from some of those people that even medicated, the pain can get so severe that suicide seems like a viable alternative.  That's my fear here.  I fear that the FDA's absolutely assinine decision to keep people from the medication that they've relied on for decades (certainly in my case) will result with peoples death on their hands.  This is just idiocy on the FDA's part and they're putting the public's health at risk.

 

I think I have enough Midrin to last me the remainder of this year, and I'm going to save it for the Migraines that won't respond to anything else.  But I just want to cry when I consider the day when I'm writhing in bed, vomiting from pain that's not responding to anything that my Dr can prescribe.  That day's coming for me, and I'm sure it's already here for many of us.  Has anyone considered organizing to inform the FDA around this?  Facebook or something?

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Teri Robert, Health Guide
4/11/11 9:40am

Wheels,

 

I hear you, but I don't really see that the FDA is at fault here. The bottom line is that these medications never went through any clinical trials or approval process. The companies making them had MANY years (like 50+) to do the clinical trials and apply for FDA approval so that they could stay on the market, but none of them did it.

 

The FDA doesn't have the authority to tell the pharmaceutical companies that they can keep making these medications without doing the trials and going through the approval process. That would be in violation of federal law.

 

The big question in my mind is why none of the companies did what they had to do to keep their drug on the market.

 

Teri

Reply
Wheels, Community Member
4/11/11 10:37am

There's no allowance for approval based on those five decades proven, safe, effective use and a huge backlog of prescriptions from people who have a need?  Five decades of evidence should trump any clinical trial.  All we're asking is that a little practical wisdom be exercised on the part of whoever has the authority to say, "You know what, five decades of use is clinical trial enough and we need to get this back out there for those people who are suffering."  It might not be the FDA, god forbid it might mean a change in federal law, but someone somewhere has to have that authority and if this kind of allowance isn't already built in, shame on whoever put the system in place for not considering this very scenario.

 

I only speculate, but I think the reason that the pharmacutical companies didn't do clinical trials earlier is the same reason they're not doing them now.  "Company A" could invest the millions it would take for a clinical trial, the FDA would approve it, then Companies B through Z would all be able to start making Midrin again because the patent has expired and whoever wants to make a generic can.  So if that's the case, what's in it for "Company A" to ever make the investment?  It would be like giving money to Companies B through Z.  If that's why we're not seeing anyone step up to get approval now and there's no adaptability in the FDA (or whoever's) rules to account for the proven reality of drugs like Midrin, it sounds like the best thing for people like me to do is to get better at suffering.

 

Thanks for the feedback Teri.  I do appreciate it...I'm just fearing the future.

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Teri Robert, Health Guide
4/11/11 10:54am

Hey, Wheels, discussion is good. I know you're discussing, not arguing with me. That's great.

 

While we're having this discussion, let me bring up something that concerns me about these drugs. We don't really know the safety record of them. Since they weren't FDA approved, they haven't been in the MedWatch system for problems to be reported, and there were very limited listings of possible side effects or warnings in the information that came with them because they didn't have the kind of labeling / prescribing information that we get with the drugs under today's approval system.

 

So, since there was no warning on them for people with heart or stroke issues, they were considered safe for those patients. But, the triptans and ergotamines carry a warning. In fact, they're contraindicated for people with a history of or risk factors for heart or stroke issues. The reason is that they have vasoconstrictive properties - they constrict blood vessels. One of the ingredients in the Midrin drugs is isometheptene mucate, wich is a vasoconstrictor. That doesn't worry some doctors, but some doctors I know feel that the Midrin drugs are/were no safer than the triptans or ergotamines. I have to wonder if that's another factor in why none of the companies making those drugs put them through the clinical trials and FDA approval process. Were they concerned that they'd end up with the same kind of warning as the triptans? We'll never know. But my point is that if they should carry that warning, having them go through clinical trials and the FDA approval process would be a good thing for patients.

 

Anyway, at this point, Prodrin is an option. It doesn't have the sedative that Midrin had, but does have caffeine. Another option is having a compouding pharmacy make a Midrin equivalent.

 

Teri

Reply
queenbeejo, Community Member
4/19/11 8:46am

It is alot of work that they probably don't want to do. Perhaps it is not a big money maker so not worth the effort.

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MissingMidrin, Community Member
4/25/11 3:57pm

Have they discontinued making Prodrin as well?  it has two of the ingredients in Midrin and I was looking to give it a try.  I've tried Maxalt - worthless.  Imitrex - doesn't take care of the migraine like the midrin did - and no "migraine hangover" after midrin.

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Wheels, Community Member
4/25/11 4:13pm

I had a Prodrin prescription filled last week so yes, it's still being made.  My pharmacy (part of a large grocery store chain) didn't have it in house, but they were able to order it.  Warning about the price:  $125/50 pills which I had to pay in full because I'd not hit my copay yet.  Really missing Midrin now.  No Migraine since I got the Prodrin so no chance to give it a try.

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sevenof9fl, Community Member
5/10/11 10:02pm

Does anyone know if Midrin or it's generics are available in Europe and/or Canada?

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wingsandwaves, Community Member
7/31/11 11:48am

I have had no luck with my search in Canada or Mexico. I am looking at compounding pharms and Prodin.

 

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Allie, Community Member
6/21/11 10:32pm

I wanted to know if you have found a pharmacy that does the compound?  If you could email me the site I would be forever grateful.  Like you , I have suffered from Migraines since I was 16, I am 45, and have tried everything. Midrin is the only thing that gets me thru a migraine. I hope you can find something, and if I can, I will let you know. Have a Blessed Day! Thank you.   Allie  

 

Moderator's Note: For your security and privacy, please do not post personal information such as email addresses and phone numbers.

Reply
Teri Robert, Health Guide
6/21/11 11:32pm

Allie,

 

Have you checked for a compounding pharmacy in your area? I don't know of any online compounding pharmacies. If you look at some of the other answers to this question, though, at least one person has shared a pharmacy name and phone number.

 

Teri

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kweston29, Community Member
5/17/11 4:00pm

I have been taking Imitrex for year's and always had side effects with this type of medication.  My doctor just this month prescribed what the pharmacist called midrin.  I find that I am taking it more often than I noticed taking other medications (at least 3 times a week).  I guess I should go ahead and get a refill of the medication since everyone says that it is not available anymore.

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bethm214, Community Member
5/21/11 10:47am

Can you please tell me where you found Midrin???? I would likely be willing to drive or fly there to get my prescription filled. Seriously. Thanks for your reply.

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Teri Robert, Health Guide
5/21/11 11:09am

It's highly unlikely that you're going to find it anywhere. The only way would be if it's been sittting on a shelf in a pharmacy for a couple of years. It's been that long since it was made now. If none of the triptans or ergotamines work for you, or if you can't take them, your best bet is for your doctor to give you a prescription to take to a compounding pharmacy. They can make a Midrin equivalent for you. The prescription will need to be for Isometheptene Mucate USP, 65 mg, Dichloralphenazone USP, 100 mg, and Acetaminophen USP, 325 mg.

 

Hope this helps,

Teri

Reply
kweston29, Community Member
5/23/11 8:59am

I went to a compounding pharmacy in Dallas, TX called Dougherty's.  It has been around since the 1950's and the people are really nice.  They also do mail orders but the pharmacists who gave me the script said it was the last batch (I think it was about 4 or 5 perscriptions worth and mine had 60 pills) of it that he had.  He is trying to find the compounds.  I had never heard of this before and he said it will likely be my miracle drug.  You could give them a call and see if they still have some.  They have a website doughertys.com.  Hope this helps

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midrinsavedme, Community Member
6/ 9/11 7:51pm

http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.thepetitionsite.com%2F5%2Fhelp-bring-midrin-back%2F&h=ebeb8

 

PLEASE SIGN THIS PETITION TO BRING MIDRIN BACK

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Solstice, Community Member
6/10/11 4:30am

I was having the same trouble as all of you guys were - desperate for my midrin. Heck, I was using "vintage 2008" midrin with extra prescription ketoprofen chasers there for a long while. I finally found a compounding pharmacy here in Delaware that could get all of the ingredients in midrin and make me some. It took a long time to get the one ingredient that everyone else has had trouble getting but they got it in stock a couple of weeks ago. I had them remove the acetominaphen (sp) from the formula and replace it with prescription ketoprofen for me because I've used it successfully for years and since its in NOTHING you can't possibly overdose on it unless you take too much (ie its not hiding in your cold meds etc). They even special ordered red capsules for me so it would look closer to name-brand midrin, which also is useful since for 20+ years my migraine meds have been red and all of my other painkillers etc have been white or blue - makes grabbing a dose when you're in pain and not able to concentrate much easier. Since somebody else posted the name of their pharmacy I hope its not a problem if I post mine - the pharmacist promised me he ordered enough ingredients to make some for other people and that he'd ship. He felt really bad for me once I explained how much of a problem the lack of midrin was for so many migraine sufferers. After all, it was my only prescription for migraines for over 20 years... But anyway, its Saveway Compounding Pharmacy located in Newark Delaware. Quick internet search will find it. If you email them and say you heard they can make midrin they will know exactly what you want. You'll just need your doctor to write the script with the ingredients (feel free to sub out another pain killer, they can do that). Then you can ask for different colored capsules or whatever you want. When I ordered 60 pills (with refills of course) with ketoprofen it ran around $1 a pill - which I was thrilled to pay. Pharmacist told me some insurance companies will reemburse too.

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Julia Sue, Community Member
6/21/11 11:41pm

I am now waiting for my compounded Midrin-equivalent capsules to arrive in the mail from the SaveWay Compounding Pharmacy in Newark, DE. Thank you so so so much for sharing this resource. They are wonderful, kind, helpful, & efficient! Since I am out of state, and my doctor preferred to give me a written/paper prescription (instead of calling or faxing the Pharmacy), I needed to mail the original prescription to SaveWay. I've also informed the compounding pharmacy that I like to use here in Maryland, but which could not get the sedative ingredient of 'midrin', and now they will be checking to see where SaveWay has been able to obtain it. Midrin is the only drug that has ever helped me, for decades, and I am so appreciative of being able to get a compounded version. Thank you again!

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Solstice, Community Member
7/21/11 4:34am

Sorry for the late reply back - so glad it could help you. I've used mine a bunch of times since I got it refilled and my custom version with the ketoprofen instead of tylenol works great. Its so nice to not be sitting there counting the pills thinking, should I take it or should I try to just take a plain painkiller and pray it works. Prayer may be remarkably effective for many things, but migraines don't seem to be one of them. Then again, on the plus side all my prayers to just die during a migraine haven't been answered either so I guess thats a bonus.

 

There was a study published recently that suggested that many people have migraine symptoms up to a day or so before the actual migraine. Before the auras and other visual disturbences we're all used to, things like mood swings, food cravings (often for the foods that give us migraines), dizziness etc. The study suggested that taking the migraine meds THEN instead of waiting for the onset of the auras or actual headache could stop many migraines in their tracks.

 

Now that I've got a full bottle of pills and the ability to get refills I've tried this a few times - thought back to how I felt the previous day before I got a migraine and tried to figure out if there were any symptoms and then take my pills when it happens again. It seems to work, its possible I wasn't going to get a migraine those days anyway. I figure after a few more months I'll know if I'm really ending up with less actual migraines by trying that or not.

 

 

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Ritu, Community Member
6/13/11 12:38pm

I would like to share this information with all my friends that have same question and confusion in mind about Midrin or Midrin Equivalent. There is a new Compounding Pharmacy in town called, 15RX Pharmacy at State Hwy 151 and Military drive. There ph. no. is 210-684-1579. You can google there address or call them to find out more info. They are nicest people who work closely with doctors to find solution to problems like this. My friend just got her Midrin equivalent filled with them and is really satisfied.

Hope this helps!

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lauralynn007, Community Member
7/23/11 9:34am

Did they say "why" they discontinued it?  Was there something in it that was dangerous?

 

I am in the boat with the rest of you.  Woke up with a killer migraine (again) and have only a few generic Midrins left....

 

The new medicine she gave me doesn't work at all.

 

Anyone know why they took it off the market?

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Teri Robert, Health Guide
7/24/11 11:50am

lauralynn,

 

Midrin was an old drug that was developed before the current FDA approval system. Manufacturers had many years to conduct clinical trials and apply for FDA approval, but they didn't do it.

 

You can read more about this in Migraine and Midrin-Like Medications Update, 1/15/11.

 

One thing you can do is ask your doctor for a prescription that can be taken to a compounding pharmacy where they can make a Midrin equivalent medication for you.

 

Teri

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salij, Community Member
7/25/11 1:27pm

I am having a problem getting my md to write a prescription for the midrin for a compounding pharm.  Any suggestions?

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Teri Robert, Health Guide
7/25/11 10:57pm

salij,

 

What reasons has your doctor given? What has he or she offered you instead of Midrin?

 

Teri

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salij, Community Member
7/27/11 5:26pm

the only reason offered so far is that they're concerned that the compounding pharms I've found on this site are legit...after speaking to one it appears fine to me...I have been given muscle relaxers which made me a zombie for 2 days...I am currently taking hydrocodone (low dose) which helps somewhat...I will not take any vaso constrictors, I have a family history of cardiovascular illness...

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Teri Robert, Health Guide
7/27/11 6:27pm

salij,

 

You can probably find a compounding pharmacy close to you, which would make you and your doctor more comfortable.

 

However, regarding your comment about not taking vasoconstrictors - the isometheptene mucate in Midrin IS a vasoconstrictor. In fact, I know some Migraine specialist who, for that reason, don't think Midrin is any safer than triptans if someone has cardiovascular risk factors.

 

Teri

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salij, Community Member
7/29/11 12:52pm

from what I know, midrin is a vasodilator

 

I spoke w/pharmacist from Del and he says that the chemicals for midrin are difficult to obtain but he knows where to get them...

 

all I know and care about is that midrin works for me and I'm not going to be a guinea pig anymore, I've taken enough drugs to choke a horse.

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Teri Robert, Health Guide
7/29/11 1:19pm

Salij,

 

The choice is yours, of course. Still, I need to tell you that the isomehteptene makes Midrin a vasoconstrictor, not a vasodilator. Vasodilators would be counterproductive for Migraine because vasodilaton is part of what can occur in the brain and part of the problem. You can confirm that at http://www.medicinenet.com/acetaminophen-isometheptene-dichloralphenazone/article.htm, where it states, "Isometheptene helps to narrow the widened blood vessels in the head."

 

Good luck,

Teri

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Maki808, Community Member
7/29/11 7:31pm

You can still get Midrin using a Compounding Pharmacy. I use www.nbfcp.com.

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brainpain, Community Member
8/ 4/11 5:09pm

Based on what my pharmacist tells me, a new generic version of midrin was introduced last month. You might want to go and check again with your pharmacy.

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RareRob, Community Member
8/ 9/11 10:50pm

I used midrin for some time and when i could not find it any more my doctor suggested Prodrin. for all of you that found midrin really effective, i can tell you prodrin at least for me is even better. i find the symptoms go away very quickly and last. only downside is cost. i am on aetna and its still about $1 a pill. as a family member said its the best dollar you can spend. so except for cost--this is a perfect replacement for midrin. hope this helps robert

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Wheels, Community Member
8/10/11 7:46am

Funny, I was going to post my post-Midrin experiences too.  What I've found is that if I have an onset during waking hours (aura, blind spots) so that I can dose myself, the Prodrin works quite nicely.  As I understand it, Prodrin doesn't have the sedative of Midrin so it's easier to continue to function while medicated.  The story isn't as rosy for my nighttime onsets...

 

I awoke yesterday with what felt like a mild headache.  I figured that after my morning cup of coffee (1 cup, daily, I've found buffers my system for better resilience to caffeine...but if I miss that one cup, hello migraine), the headache would probably go away.  Bad assumption.  By 10AM I was in a meeting and the pain was so intense that I was nauseous.  I left the meeting, took a Prodrin, and went home to sleep it off.  I woke up with the migraine diminished, had lunch, and returned to work.  But the migraine returned in full force and by the time I went to bed last night, I had two more Prodrin in my system and resisting the urge to be sick.  I awoke this morning and things were back to normal, thankfully.

 

Midrin was more effective for me with the nighttime onsets.  This was the 3rd or 4th time that I've been through the scenario above with Prodrin.  My script says I can take 1 or 2 pills and I've only been taking 1 because it's new to me, so the next time I'm going to hit it with 2 and cross my fingers.  I've posted here how the triptans have - or rather haven't - worked for me.  I've all but given up on Fioricet, it's a lost cause with my migraines.

 

Brave new world without Midrin, and I'm too stubborn to try the compounding Pharms.  If the drug co's can't get all the ingredients, it seems like it's only a matter of time before the compounders can't.  Might as well adapt now.

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salij, Community Member
8/10/11 7:12pm

Midrin never had any sedative effect on me.  I will ask my dr about the Prodrin. thx

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suzyq01, Community Member
8/20/11 12:46am

After a three-day migraine and a dwindling supply of Midrin, I decided to renew my efforts to find the drug. I've already cleaned out all of my local pharmacies. Here's what I found out. My local compounding pharmacy and my local pharmacy all have the generic brand NOW in stock! Aug. 19, 2011. I told my doctor this and he immediately called in my prescription. I got a bottle of 100 -- the label has this information on it:

   Isometheptene Mucate, Dichloralphenazone and Acetaminophen Capsules, USP 65 mg/100 mg/325 mg. The manufacturer is Macoven Pharmaceuticals, LLC of Magnolia, TX. I have never heard of this manufacturer.

   Hope this helps others! Good Luck!

 

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dianewa, Community Member
4/27/12 3:39pm

Thank you!!!  I was able to contact Macoven today and find out where they distribute it to.  Walmart, Target, Walgreens and CVS.  Thanks to your info I am now about to get a new supply of the only migraine meds that work for me.  I thought I was going to die yesterday when my doctor told me it was discontinued.  I just got close to the bottom of my last coveted bottle of midrin that I have been tight fisting for the last year.

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Morganathered, Community Member
9/12/11 11:33pm

My migraines are to the severity level that they cause temporal lobes seizures, I blackout ending up in the hospital. In May 2011, the hospital doctor gave me MIDRIN. The migraines stopped. When she prescribed the medication for me, my pharmacy said this product was no longer available. I'm having terrible "blackout" migraines, confusion again. I'm on Prodrin but it doesn't help without sedatives. Two new neurologists are not helpful. What medication do you suggest to stop the migraines?

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Wheels, Community Member
9/13/11 10:55am

I took the info in the post above yours (re: a new Midrin generic being available) to my family doctor and they confirmed it and called in a script to my pharmacy who confirmed it too.  I have a fresh bottle of 60 pills and when I picked it up the pharmacist said, "We were all so happy to hear that this is available again!"

 

Before all of that happened, I tried to redirect the script to the CVS pharmacy that my wife prefers because she was heading there that afternoon and could save me a trip.  The CVS pharmacist said that Midrin's gone and it's not coming back.  I explained the post above yours and even gave the company's info to the pharmacist but he was having none of it and told me to forget about it.  Very rude.  So my experience is that word of this new generic is slow to get out and not everyone believes it.

 

Take care and best of luck!

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Kiahtah, Community Member
4/14/12 2:27pm
This is ridiulous Midrin was THE ONLY PILL that worked! Reply
dianewa, Community Member
4/27/12 3:36pm

See my post below.  Macoven does distribute the generic form to Walmart, Target, Walgreens and CVS.

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dianewa, Community Member
4/27/12 3:35pm

Hi everyone.  I wanted to let you all know that I actually was in contact with Macoven Phamaceuticals this morning 4/27/2012.  They do make and distribute the generic form of Midrin but do not call it Midrin they call it: Isometh/Dichlor/APAP.  Here is the email with the information.  Turns out it is available at Walmart, Target, Walgreens and CVS. I just got off the phone with my local walmart here in Washington and they stock it.  It comes in a 60 capsule supply and runs about $95.  I just had my doc call in to get a new script!  Hope the rest of you can locate this in your area. If not, contact the Macoven directly at:

 

http://pernixtx.com/macoven-pharmaceuticals/

CUSTOMER SERVICE
Phone: 877-622-6836
Fax: 225-647-6798
Email: customerservice@macovenpharma.com

 

Hi Diane,

Yes, our product is called Isometh/Dichlor/APAP. It is available at any Wal-Mart, Walgreens, Target or CVS.

Thanks and have a great day!
Cindy

 

 

RE: Trying to locate Isometheptene Mucate, Dichloralphenazone and Acetaminophen Capsules, USP 65 mg/100 mg/325 mg‏

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jolivi9, Community Member
5/22/12 2:17pm

I have actually been since prescribed Prodrin, which is the same thing as Midrin minus the sedative plus caffiene as my doctor told me.  Works exactly the same.

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Teri Robert, Health Guide
5/22/12 6:08pm

Prodrin has also been discontinued. The only equivalent medication still on the market is the one from Macoven. Otherwise, the only choice is having it compounded. We're keeping a link on our site homepage with the most current informaiton available on the situation.

 

Teri

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mhrn, Community Member
6/20/12 2:21am

After battling migraines for ten years, Midrin was the only thing that worked for me. When they got extremely severe occassionally I would have to go to the ER fot either Nubain/Phenergan ot Vistaril or Demerol/Phenegan injection. After I could no longer get generic Midrin thanks to the FDA... I had to take Stadol nasal spray and then because it was too strong, Lortab, poor choices since opiates can cause rebound headaches. I finally started getting Midrin compounded locally. The price went from $5 copay to $130 as my insurance didnt cover compounded meds. luckily I am an RN and explained my situation to a doctor who both trusts me and was willing to work with me for an alternative. I know most doctors would never Rx chloral hydrate these days as it has been displaced by safer meds and has a narrow therapeutic range... He agreed, after I approached him with the idea. I take 2 BC powders or 2 Excedrin migraines and a Somnote which he does Rx for me. BC contains caffeine, an effective cranial vasoconstrictor as well as Tylenol and the aspirin also helps. It works wonders. Though each somnote does contain 500mg chloral hydrate.  Fortunately I am minimally affected by sedatives and it doesn't make me sleepy.

 

I doubt this is an option for the majority. True: most doctors pro ably won't even use CH anymore, much less at the responsibility of the patient taking the correct combination of OTCs with it. All I can say is shame on the FDA. The drug is so old that it has stood the test of time as safe yet it is old and has not undergone the newer clinical trials, but millions have found relief in Midron when either nothing else worked or they, like myself, couldn't afford triptans at $75 For six maxalt!... This leaves three optiow doctors are forced to prescribe less desirable AND less effective  combinations containing narcotics

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Dawna, Community Member
8/23/12 4:09pm

Good news - a generic of midrin is back on the market. It is made by Macoven. I went to the pharmacy today to have my Midrin compounded and was told there is a generic. She actually filled my prescription with the generic. Interesting it cost over $20 more than compounding but happy it is back. Now my insurance will pay for it.

 

Warning - it is back on a temporary basis. Hopefully, it will become permanent.

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Ateddymd, Community Member
6/ 7/14 3:53am
I am a MD with chronic daily migraines and do not want to take narcotics. Midrin is the only med that worked for me can you advise me. Thank you Doc Reply
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By Jan Davis, Community Member— Last Modified: 06/07/14, First Published: 12/05/10