Myguard Nasal Spray

Introduction
Myguard Nasal Spray is used to treat acute migraine attacks. It works by narrowing the blood vessels, thereby relieving migraine headaches and preventing the attack from becoming worse. Myguard Nasal Spray may be taken with or without food. Never skip any doses and try to finish the full course of treatment even if you feel better. In case you missed a dose, take it as soon as you remember it. You should continue to take this medicine as long as the doctor advises and do not stop taking it suddenly. Side effects associated with the use of this medicine include dizziness, dryness in mouth, nausea, sensation of heaviness, warm sensation, tightness sensation, cold sensation, drowsiness, fatigue, and peripheral neuropathy (tingling and numbness of feet and hands). It may cause dizziness, do not drive or operate machinery until you know how this medicine affects you. However, these are temporary and usually resolve on their own in some time. Please consult your doctor in case these do not subside or bother you. Consult your doctor if you develop stomach pain, bloody diarrhea, or worsening high blood pressure while taking Myguard Nasal Spray. Your doctor may advise for regular eye checkups if you have been taking this medicine for a longer time. In case you experience severe chest pain that does not go away or you have wheezing, breathing problems, or any skin rashes, contact the doctor as soon as possible. This medicine may cause an increase in blood pressure, keep a check on your blood pressure while taking this medicine.

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Uses of Myguard Nasal Spray
Acute migraine headache
Side effects of Myguard Nasal Spray
Common
Dizziness
Dryness in mouth
Nausea
Heaviness
Flushing (sense of warmth in the face, ears, neck and trunk)
Tightness sensation
Feeling of cold
Drowsiness
Fatigue
Peripheral neuropathy (tingling and numbness of feet and hand)
How to use Myguard Nasal Spray
Take this medicine in the dose and duration as advised by your doctor. Do not handle the strips/film with wet hands. Keep it in your mouth but do not swallow it. Myguard Nasal Spray may be taken with or without food, but it is better to take it at a fixed time.
How Myguard Nasal Spray works
Migraine headaches occur due to the dilatation (swelling) of blood vessels in the head. Myguard Nasal Spray works by narrowing these blood vessels, thus relieving the migraine headache.
Quick Tips
You have been prescribed Zolitas ODS 5 Strip for treatment of migraine headaches.
Some tips that may help avoid a migraine attack:
It may cause sleepiness. Don’t drive or do anything that requires mental focus until you know how it affects you.
Notify your doctor if your migraine occurs more often after starting the medication.
Notify your doctor if you have stomach pain, headache, bloody diarrhoea or worsening high blood pressure.
Inform your doctor if you have a history of heart disease or stroke.
This medication does not prevent migraine attacks from happening.
Brief Description
Indication
Acute migraine attacks
Administration
May be taken with or without food.
Adult Dose
Oral Acute migraine attacks Adult: Initially, 2.5 mg. A 2nd dose may be taken at least 2 hr after the 1st dose if symptoms recur within 24 hr. Max dose: 10 mg in 24 hr. Safety of treating > three headaches in a 30-day period has not been established. Hepatic impairment: Dose reduction may be needed with BP monitoring. Moderate to severe: Max dose: 5 mg/24 hr

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Renal Dose
After orally dosing zolmitriptan, renal clearance was Reduced by 25% in patients with severe renal impairment (Clcr ?5 ?25mL/min) compared to the normal group (Clcr ?70 mL/min); No significant change in renal clearance was observed in the moderately renally impaired group (Clcr ?26 ?50 mL/min).

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Contraindication
Patients at risk of coronary artery disease (post-menopausal women, men >40 yr, hypertension, hypercholesterolemia, smoking, obesity, DM, family history of coronary artery disease) unless evaluated. Wolff-Parkinson-White syndrome; arrhythmias associated with accessory cardiac conduction pathways; previous cerebrovascular accident; uncontrolled or severe hypertension; ischaemic heart disease, history of MI, coronary vasospasm, transient ischaemic attack. Basilar or hemiplegic migraine.

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Mode of Action
Zolmitriptan is a selective agonist for serotonin (5HT1 receptors). It relieves migraine by selective constriction of intracranial blood vessels, neuropeptide release inhibition and decreased transmission in the trigeminal pain pathway.
Precaution
Use only if there is a clear diagnosis of migraine; exclude other potentially serious neurological conditions. Monitor BP closely. May impair ability to drive or operate machinery. Pregnancy and lactation. Child. Moderate to severe hepatic impairment. Prior CV evaluation for patients with risk factors of coronary heart disease; admin of first dose under close supervision and ECG if satisfactory CV assessment in these patients. Periodic CV evaluation for patients with risk factors of coronary arteries on zolmitriptan. Avoid oral disintegrating formulation for patients with phenylketouria. Long term use may cause accumulation of zolmitriptan in melanin rich tissue (e.g. eye). Lactation: unknown, use caution

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Side Effect
1-10% Dizziness (6-10%),Neck/throat/jaw pain (4-10%),Parasthesia (5-9%),Nausea (4-9%),Weakness (3-9%),Somnolence (5-8%),Warm/cold sensation (5-7%),Xerostomia (3-5%),Chest pain (2-4%),Diaphoresis (3%),Pain (2-3%),Dyspepsia (1-3%),Dysphagia (2%),Myasthenia (2%),Palpation (2%),Vertigo (2%),Hypoesthesia (1-2%),Myalgia (1-2%) <1% QT prolongation,Bradycardia,Tachycardia,Thrombophlebitis,Postural hypotension,Hyperglycemia,Alk phos increased,Arthritis,Twitching,Myocardial infarction and artery vasospasm in patients with CAD risk factors Potentially Fatal: Cardiac arrhythmias, MI, subarachnoid haemorrhage. _ Interaction Increased risk of serotonin syndrome with SSRI, selective serotonin- and norepinephrine-reuptake inhibitors (SNRI). Increased zolmitriptan concentrations with cimetidine, quinolone antibacterials and drugs that inhibit the cytochrome P450 isoenzyme CYP1A2. Potentially Fatal: Increased risk of fatal serotonin syndrome with sibutramine. Increased risk of serotonin syndrome with MAOI and reversible inhibitors of monoamine oxidase type-A (RIMA); do not use zolmitriptan during and for 2 wk after the use of MAOI and RIMAs Do not use within 24 hr of treatment with another 5-HT1 agonist. Increased risk of additive vasoconstriction with ergot alkaloids; zolmitriptan should not be taken within 24 hr of any ergotamine or ergot-type medication. _