Sandomigran Ds

The dose of Sandomigran DS (Pizotifen) is usually started low (0.5 mg at bedtime) and increased gradually to 0.5 mg 3 times daily. The average maintenance dose is 1.5 mg per day. The dose range is 1 mg to 6 mg daily depending on the response to the medication. The goal is to reach the lowest dose that best prevents migraine headaches without causing significant side effects. It may take up to 4 weeks for the medication to have its maximum effect.

Your doctor may have you gradually reduce your dosage after having success with it to determine if you still need the medication. Your dose will be reduced gradually to prevent a "rebound" headache. If your headaches return after you have stopped taking the medication, your doctor may prescribe Sandomigran DS (Pizotifen) again.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Sandomigran DS (Pizotifen) exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Sandomigran DS (Pizotifen) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Each whitish, compressed tablet contains 1 mg of Sandomigran DS (Pizotifen). Nonmedicinal ingredients: lactose, magnesium stearate, and microcrystalline cellulose.

Do not take Sandomigran DS (Pizotifen) if you:

• are allergic to Sandomigran DS (Pizotifen) or any of the ingredients of the medication
• are taking monoamine oxidase (MAO) inhibitors (e.g., Tranylcypromine or Phenelzine)
• are under the age of 12 years
• have a pyloroduodenal obstruction or stenosing pyloric ulcer
• have lactose intolerance, galactose intolerance, or glucose malabsorption (a rare hereditary disease)

There may be an interaction between Sandomigran DS (Pizotifen) and any of the following:

• aclidinium
• alcohol
• amantadine
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Haloperidol, Perphenazine, Quetiapine, Olanzapine, Risperidone)
• atropine
• azelastine
• barbiturates (e.g., Phenobarbital, butalbital)
• belladonna
• benzodiazepines (e.g., Diazepam, Lorazepam)
• Benztropine
• Betahistine
• botulinum toxin
• brimonidine
• Buprenorphine
• Buspirone
• cannabis
• cholinesterase inhibitors (e.g., Donepezil, Galantamine, Rivastigmine)
• chloral hydrate
• Disopyramide
• Domperidone
• efavirenz
• Eluxadoline
• Flavoxate
• Glucagon
• glycopyrrolate
• glycopyrronium
• ipratropium
• ketotifen
• magnesium sulfate
• Metoclopramide
• Mirabegron
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Rasagiline, phenelzine, Selegiline, tranylcypromine)
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine)
• Nabilone
• narcotic pain relievers (e.g., Codeine, Morphine)
• Nitroglycerin
• Oxybutynin
• potassium supplements
• Pramipexole
• Ropinirole
• Rotigotine
• scopolamine
• seizure medications (e.g., Clobazam, Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Paroxetine, Sertraline)
• sodium oxybate
• Solifenacin
• suvorexant
• Tapentadol
• thalidomide
• thiazide diuretics (e.g., Hydrochlorothiazide, Chlorthalidone)
• tiotropium
• Tolterodine
• topiramate
• Tramadol
• tricyclic antidepressants (e.g., Amitriptyline, Desipramine)
• umeclidinium
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Sandomigran DS (Pizotifen). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Sandomigran DS (Pizotifen).

Drowsiness/reduced alertness: Drowsiness or dizziness may occur with use of Sandomigran DS (Pizotifen) and this may impair your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how Sandomigran DS (Pizotifen) affects you.

Liver problems: Decreased liver function or liver disease can cause Sandomigran DS (Pizotifen) to build up in the body, causing side effects. Long-term use of Sandomigran DS (Pizotifen) may also cause changes in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Medical conditions: People with narrow-angle Glaucoma, urinary retention (e.g., enlarged prostate), Diabetes, heart disease, seizures, or reduced kidney or liver function should discuss with their doctor how Sandomigran DS (Pizotifen) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Sandomigran DS (Pizotifen), and whether any special monitoring is needed.

Tolerance: With prolonged use of Sandomigran DS (Pizotifen), some people find that it no longer works successfully. If this happens, contact your doctor.

Withdrawal: If Sandomigran DS (Pizotifen) is stopped suddenly, you may experience withdrawal symptoms such as anxiety, sweating, trouble sleeping, shaking, pain, nausea, tremors, diarrhea, and hallucinations. Do not stop taking Sandomigran DS (Pizotifen) without talking to your doctor or pharmacist.

Pregnancy: Sandomigran DS (Pizotifen) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Sandomigran DS (Pizotifen), contact your doctor immediately.

Breast-feeding: It is not known if Sandomigran DS (Pizotifen) passes into breast milk. If you are a breast-feeding mother and are taking Sandomigran DS (Pizotifen), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Sandomigran DS (Pizotifen) have not been established for children under 12 years of age.