How does this medication work? What will it do for me?

Pizotifen is used to prevent migraine headaches. It is not used to treat headaches once they have started. It is not known exactly how this medication works, but it is thought to affect chemicals, called neurotransmitters, in the brain. It may take up to 4 weeks for the medication to have its maximum effect.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each ivory-coloured, sugar-coated tablet contains pizotifen 0.5 mg. Nonmedicinal ingredients: cornstarch, lactose, magnesium stearate, povidone, and talc.

How should I use this medication?

The dose of 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 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 this medication 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 this medication 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.

Who should NOT take this medication?

Do not take pizotifen if you:

  • are allergic to 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)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dizziness
  • drowsiness
  • dry mouth
  • fatigue
  • increased appetite
  • nausea
  • weight gain

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • aggressive behavior or agitation in children
  • depression
  • low blood pressure
  • muscle pain
  • sensation of tingling and/or prickling
  • vision changes
  • yellowing of the skin or eyes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • seizures or hallucinations
  • symptoms of a severe allergic reaction (e.g., hives, difficulty breathing, swelling of the throat or mouth)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

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 this medication.

Drowsiness/reduced alertness: Drowsiness may occur with use of pizotifen and this may impair your ability to drive or operate machinery. Avoid these activities until you find out whether the medication affects you in this way.

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 this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Tolerance: With prolonged use of pizotifen, some people find that it no longer works successfully. If this happens, contact your doctor.

Withdrawl: If this medication 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 this medication without talking to your doctor or pharmacist.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

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

Children: The safety and effectiveness of using this medication have not been established for children under 12 years of age.

What other drugs could interact with this medication?

There may be an interaction between pizotifen and any of the following:

  • aclidinium
  • alcohol
  • amphetamines
  • antipsychotics (e.g., haloperidol, quetiapine, olanzapine, risperidone)
  • barbiturates (e.g., phenobarbital, butalbital)
  • benzodiazepines (e.g., diazepam, lorazepam)
  • betahistine
  • botulinum toxin
  • brimonidine
  • cannabis
  • cholinesterase inhibitors (e.g., donepezil, galantamine, rivastigmine)
  • doxylamine
  • droperidol
  • ipratropium
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, rasagiline, phenelzine, selegiline, tranylcypromine)
  • narcotic pain relievers (e.g., codeine, morphine)
  • orphenadrine
  • other anticholinergic medications (e.g., benztropine, diphenhydramine, oxybutynin)
  • paraldehyde
  • perampanel
  • phenothiazines (e.g., perphenazine, thioridazine)
  • potassium supplements
  • pramipexole
  • ropinirole
  • rufinamide
  • scopolamine
  • sedatives
  • selective serotonin reuptake inhibitors (SSRIs; e.g., paroxetine, sertraline)
  • sleeping pills
  • sodium oxybate
  • solifenacin
  • tapentadol
  • thalidomide
  • thiazide diuretics (e.g., hydrochlorothiazide, chlorthalidone)
  • tiotropium
  • topiramate
  • 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 this medication. 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.