Medication for migraines – InformedHealth.org

Migraine attacks can be treated with painkillers or migraine medication. If needed, medicine for nausea and vomiting can be taken as well. But if painkillers are taken too often, they themselves may cause headaches.

Lying down in a dark, cool room may be enough to relieve mild migraines. Migraines are usually very painful, though, so most people take medication to get through them. Over-the-counter painkillers may be effective enough for moderate pain. But stronger medication may be needed for more severe migraines. If you often have migraines, it’s a good idea to have different kinds of medicine on hand.

The following medications can be used to treat migraine:

• Anti-nausea medication (antiemetics)

• Special migraine medication (triptans and ergotamines) 

Can painkillers like acetylsalicylic acid or acetaminophen (paracetamol) help?

NSAID painkillers have been shown to effectively relieve migraine pain. The most commonly used painkillers in Germany are acetylsalicylic acid (ASA, used in medicines like Aspirin), diclofenac, ibuprofen and acetaminophen (paracetamol). Research has shown that these drugs are effective in treating migraine:

• Without painkillers, migraine pain disappeared within two hours in about 10 out of 100 people.

• With painkillers, it disappeared within the same time in about 20 out of 100 people.

In other words, the pain was gone in an extra 10 out of 100 people two hours after taking the medicine. Another 20 out of 100 people can expect some pain relief. The effectiveness of a drug will depend on things like the severity of the migraine and the dose used.

Effectiveness of painkillers

The following table shows the doses commonly used to treat migraines in adults:

View in own window

What are the side effects?

Side effects are rare since painkillers are usually only used for a short time in migraine treatment. In studies, ibuprofen caused stomach ache in less than 1 out of 100 people. Other drugs didn’t have any side effects. But taking painkillers may be a problem for people who already have certain conditions, such as kidney damage.

NSAIDs can also affect the stomach lining, so they aren’t suitable for people who have stomach ulcers. Acetylsalicylic acid can reduce the blood’s ability to clot, increasing the risk of bleeding. Usually the bleeding is slight, for instance a nosebleed or bleeding gums. In rare cases it may be more serious, for example in the gastrointestinal tract. High doses of NSAIDs can also increase the risk of complications in people who have cardiovascular disease.

Acetaminophen (paracetamol) is not suitable for people with impaired liver function because it is broken down in the liver. At high doses it can even cause liver damage in people who are otherwise healthy. So it’s important not to exceed the maximum recommended daily dose.

What drugs relieve nausea?

If you feel nauseous during migraine attacks, you can take domperidone or metoclopramide in addition to painkillers. It is estimated that these drugs relieve nausea and vomiting in about 40 out of 100 people. Combination drugs are also available. They combine a painkiller with a drug for nausea relief, for instance acetaminophen (paracetamol) with metoclopramide.

How do migraine medications like triptans and ergotamines work?

Triptans

Triptans were developed specifically for the treatment of migraine. All of the triptans act to narrow the blood vessels in the brain and inhibit the release of chemical messengers that contribute to inflammation. Triptans can relieve pain and help reduce nausea and sensitivity to light. Seven different triptans are currently available in Germany:

• almotriptan

• eletriptan

• frovatriptan

• naratriptan

• rizatriptan

• sumatriptan

• zolmitriptan

Some of these drugs can be used in different forms: tablets, capsules, nasal sprays, suppositories, injection solutions or lozenges that are placed under the tongue. Injections can be given using a pre-filled pen that your doctor can prescribe. Most triptans are prescription-only. Almotriptan and naratriptan are available without a prescription.

Because of chemical differences between the triptans, they are sometimes taken in different doses. For instance, sumatriptan tablets have 50 or 100 mg of sumatriptan in them, whereas zolmitriptan tablets contain 2.5 or 5 mg of zolmitriptan. The different triptans also differ in terms of their duration of action. Some of them start working more quickly and have a shorter effect. This means that if one triptan doesn’t provide enough relief, it might be worth trying another.

All triptans can help relieve migraines. Studies on the most commonly prescribed triptan, sumatriptan (50 mg), for example, show the following:

• Without sumatriptan, migraine pain went away within two hours in about 10 out of 100 people.

• With sumatriptan, the pain disappeared in the same time in 20 to 30 out of 100 people.

So an additional 10 to 20 out of 100 people had no pain two hours later. And the drug offered at least some pain relief in another 25 out of 100 people.

Effectiveness of triptans

How quickly and effectively a drug works will also depend on the severity of the migraine, the dose of the drug and how it is administered. For instance, injections are faster and more effective than other forms of administration, but they also have more side effects.

The possible side effects of triptans include drowsiness, unusual sensations such as tingling, weakness, heat or cold, and sometimes mild nausea as well. Using a suppository or injection might help avoid nausea. But triptans aren’t suitable for people who have cardiovascular (heart and blood vessel) diseases. This is because triptans can narrow the blood vessels and increase blood pressure, although this is rare.

Ergotamines

Prescription migraine drugs may also contain ergotamines, which are made from a fungus called ergot. For nearly one century it was the only migraine-specific drug. Ergotamines are used less nowadays for the treatment of migraine attacks because they have more side effects than triptans do. The use of ergotamines for the prevention of migraines hasn’t been approved in Germany since 2014.

Which medications are suitable for children and teenagers?

Medications sometimes have different effects in children and teenagers than they do in adults. They need other doses, and some of the side effects are also different. The following medications have been approved in Europe for the treatment of migraines in children and teenagers:

• ibuprofen

• acetaminophen (paracetamol): for children ages 12 and up, also in combination with metoclopramide

• sumatriptan: as a nasal spray for children ages 12 and up

It’s not clear whether acetaminophen can relieve migraine symptoms in children and teenagers. Several studies show that ibuprofen can help relieve migraine attacks. There were no serious side effects in the studies involving children with migraines. Mild side effects like stomach ache were rare.

The sumatriptan nasal spray also helped relieve migraine attacks in children and teenagers. Mild side effects were more common though, such as an unpleasant taste or nausea.

Children and teenagers can also be prescribed medication that hasn’t been approved for their age group. This is known as “off-label use.” If your doctor prescribes a medication off-label, then he or she needs to explain why and tell you about the associated risks.

What can happen if you take painkillers too often?

Painkillers or triptans can themselves cause headaches if used too often. These headaches are known as medication overuse headaches or rebound headaches. Medication overuse headaches cause a dull pain that affects the entire head. Pain from a migraine is more of a throbbing pain, and is accompanied by other symptoms. Medication overuse headaches are chronic, occurring on more than 15 days per month for three months. People with this kind of headache may still have migraine attacks.

If you have medication overuse headaches, it makes sense to stop taking the medication for a while, even if the headache gets worse at first and there are other withdrawal symptoms such as restlessness, trouble sleeping or nausea.

Sources

• IQWiG health information is written with the aim of helping
  people understand the advantages and disadvantages of the main treatment options and health
  care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the
  German health care system. The suitability of any of the described options in an individual
  case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a
  team of
  health care professionals, scientists and editors, and reviewed by external experts. You can
  find a detailed description of how our health information is produced and updated in
  our methods.

Stomach-Safe Pain Relief for Sensitive Stomachs

Stomach-Safe Pain Relief for Sensitive Stomachs | TYLENOL®
Skip to main content

Consider Your Stomach When Choosing Your Pain Reliever

Many common over-the-counter pain relievers may cause stomach problems that can become a serious concern, especially for those at increased risk. When you take pain relief medication be sure to read the label as NSAIDs (for example: ibuprofen, naproxen sodium) may cause severe stomach bleeding.

Why TYLENOL can be a better option:

• #1 Doctor Recommended Pain Relief brand for those with stomach problems.
• TYLENOL® will not upset the stomach the way naproxen sodium (Aleve®^[1] ), or even Ibuprofen (Advil®^[1], MOTRIN®) can.
• TYLENOL® can help relieve your pain while being gentle on your stomach.
• TYLENOL® can be taken on an empty stomach.
• TYLENOL® may be a safe over the counter pain reliever for those with a history of stomach bleeding, stomach ulcers, or stomach problems such as heartburn.
• TYLENOL® is not an NSAID. NSAIDs (for example: ibuprofen, naproxen sodium) can cause stomach ulcers and an increased risk of severe stomach bleeding.

The risk of stomach bleeding associated with NSAIDs is increased in certain people including those…

WITH A HISTORY OF STOMACH BLEEDING OR STOMACH ULCERS

OVER THE AGE OF 60

TAKING A BLOOD THINNING (ANTICOAGULANT) OR STEROID DRUG

WHO HAVE 3 OR MORE ALCOHOLIC DRINKS EVERY DAY WHILST USING AN NSAID

TAKING OTHER DRUGS CONTAINING PRESCRIPTION OR NONPRESCRIPTION NSAIDS (ASPIRIN, IBUPROFEN, NAPROXEN, OR OTHERS)

TAKING MORE THAN THE RECOMMENDED DOSE OF AN NSAID OR FOR A LONGER TIME THAN DIRECTED

Acetaminophen, the active ingredient in TYLENOL® products, may be a more appropriate pain relief option if you are at increased risk of NSAID-related stomach bleeding.

Know the signs of stomach bleeding

Feeling faint.

Vomiting blood.

Having bloody or black stools.

Experiencing stomach discomfort that does not get better.

Always read and follow your pain medication label

With millions of Americans taking NSAID pain medication every day, it is important to always read and follow the medication label and be aware of potential risks associated with NSAIDs, including gastrointestinal (or stomach) bleeding.

The science behind it

Natually-occuring chemicals, called prostaglandins, help to protect the stomach lining. Similar prostaglandins are also responsible for causing pain. NSAIDs reduce pain by blocking production of these chemicals, but this can also reduce protection for the stomach lining. This increases risk for stomach conditions, such as stomach bleeding and irritation.

¹All third-party trademarks used herein are registered trademarks of their respective owners.

Learn more about product information.

Knowing how to read the label is important.

Link your social account

{* loginWidget *}

Or use your traditional account

{* #userInformationForm *}
Email Address
{* traditionalSignIn_emailAddress *}
Password
{* traditionalSignIn_password *}

{* traditionalSignIn_signInButton *}

{* /userInformationForm *}

Welcome back, {* welcomeName *}!

{* loginWidget *}

Welcome back!

{* #userInformationForm *}
{* traditionalSignIn_emailAddress *}
{* traditionalSignIn_password *}

{* traditionalSignIn_signInButton *}

{* /userInformationForm *}

{* #socialRegistrationForm *}

{* socialRegistration_firstName *}
{* socialRegistration_lastName *}

Your first name and last initial will be displayed publicly to other users when you write a review or blog post (ex. ”John S.”).

{* socialRegistration_gender *}
{* socialRegistration_zipcode *}

{* socialRegistration_emailAddress *}

Will be used as your user name

{% customQuestions %}

{% customOptin %}

Registration permits you to participate in all areas of this site. By submitting your information above, you agree that the information you provide will be governed by our site’s Privacy Policy.

{* /socialRegistrationForm *}

Link an existing social account:

{* loginWidget *}

Or create an account by providing the information below.

{* #registrationForm *}

{* traditionalRegistration_firstName *}
{* traditionalRegistration_lastName *}

Your first name and last initial will be displayed publicly to other users when you write a review or blog post (ex. ”John S.”).

{* traditionalRegistration_gender *}
{* traditionalRegistration_zipcode *}

{* traditionalRegistration_emailAddress *}

Will be used as your user name

{* traditionalRegistration_password *}

{* traditionalRegistration_passwordConfirm *}

{% customQuestions %}

{% customOptin %}

Registration permits you to participate in all areas of this site. By submitting your information above, you agree that the information you provide will be governed by our site’s Privacy Policy.

{* /registrationForm *}

{* #requirementsPostLoginForm *}
{* firstName *}
{* lastName *}
{* gender *}
{* zipcode *}

By submitting your information above, you agree that the information you provide will be governed by our site’s Privacy Policy.

{* saveButton *}
{* /requirementsPostLoginForm *}

All fields required

{* #forgotPasswordForm *}
Email Address
{* traditionalSignIn_emailAddress *}

{* /forgotPasswordForm *}

Looks like you have an existing account with us. We have made some changes to our site and we need you to create a new password in order to login. Click send to recieve an email with instructions on how to create your new password.

{* #optinUserNewPasswordForm *}
{* optinUser_emailAddress *}

{* /optinUserNewPasswordForm *}

Please check your email for a reset link to continue the reset process.

{* mergeAccounts *}

{* #tradAuthenticateMergeForm *}
{* traditionalSignIn_emailAddress *}
{* mergePassword *}

{* /tradAuthenticateMergeForm *}

{* #privacyPolicyPostLoginForm *}

By clicking “Accept” below, you confirm that you have read, understand and accept our sites’s Privacy Policy

{* /privacyPolicyPostLoginForm *}

You do not meet the minimum age requirement to sign in to this site

Your account is deactivated.

Side Effects of Motrin (Ibuprofen), Warnings, Uses

005730150_PB

round, brown, imprinted with Advil

009045853_PB

oval, white, imprinted with 4 I

009045854_PB

oval, white, imprinted with 6I

009045855_PB

oval, white, imprinted with 8I

009047912_PB

capsule, brown, imprinted with I2

433530389_PB

round, white, imprinted with IP 464

433530391_PB

capsule, white, imprinted with IP 466

433530393_PB

oval, white, imprinted with IP 465

537460464_PB

round, white, imprinted with IP 464

537460465_PB

oval, white, imprinted with IP 465

537460466_PB

oval, white, imprinted with IP 466

551110682_PB

oval, white, imprinted with 4 I

551110683_PB

oblong, white, imprinted with 6 I

551110684_PB

capsule, white, imprinted with 8I

678770294_PB

round, white, imprinted with 121

678770295_PB

capsule, white, imprinted with 122

678770296_PB

capsule, white, imprinted with 123

Ibuprofen 100 mg per 5 mL-PER

Ibuprofen 200 mg 005361088

round, brown, imprinted with 44 291

Ibuprofen 200 mg 005361089

oblong, brown, imprinted with 44 292

Ibuprofen 200 mg 009046747

round, brown, imprinted with I 2

Ibuprofen 200 mg 009047914

round, white, imprinted with 44 438

Ibuprofen 400 mg 494830602

round, white, imprinted with 121

Ibuprofen 400 mg-PAR

oblong, white, imprinted with IBU 400

Ibuprofen 400 mg-QUA

round, white, imprinted with 400, IP 131

Ibuprofen 400 mg-SCH

oblong, white, imprinted with SCHEIN 0765/400

Ibuprofen 600 mg-INT

oval, white, imprinted with IP 132, 600

Ibuprofen 600 mg-PAR

oblong, white, imprinted with IBU 600

Ibuprofen 600 mg-SCH

oblong, white, imprinted with SCHEIN 0766/600

Ibuprofen 800 mg-PAR

oblong, white, imprinted with IBU 800

Ibuprofen 800 mg-QUA

oblong, white, imprinted with 800, IP 137

Ibuprofen 800 mg-QUA

oval, white, imprinted with 800, IP 137

ibuprofen 800mg 422910442

capsule, white, imprinted with IBU 800

How to Get Rid of Nausea Fast (with Pictures)

About This Article

Medically reviewed by:

Board Certified Gastroenterologist

This article was medically reviewed by Peter Gardner, MD. Peter W. Gardner, MD is a board certified physician who has practiced Gastroenterology and Hepatology for over 30 years. He specializes in diseases of the digestive system and liver. Dr. Gardner earned his Bachelor’s degree from the University of North Carolina and attended Georgetown Medical School. He completed his residency in Internal Medicine and then his fellowship in Gastroenterology at the University of Connecticut. He is a previous Chief of Gastroenterology at Stamford Hospital and remains on the staff. He is also on the staff of Greenwich Hospital and New York (Columbia) Presbyterian Hospital. Dr. Gardner is an Approved Consultant in Internal Medicine and Gastroenterology with the American Board of Internal Medicine. This article has been viewed 1,076,469 times.

Co-authors: 18

Updated: May 6, 2021

Views: 1,076,469

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

Article SummaryX

To get rid of nausea fast, take a moment to sit still in a quiet place, since moving around can make you feel worse. As you rest, take some deep breaths to help your body relax and make your stomach feel better. You can also try making some ginger tea or eating candied ginger, since ginger is known to reduce nausea and stomach problems. If you’re still nauseous, try taking an over-the-counter medicine like Pepto Bismol, which can help calm an upset stomach. Alternatively, if you have chronic nausea, consider getting an acupressure band that puts pressure on your wrist to relieve nausea. To learn how to get anti-nausea prescription, read more from our Medical co-author.

• Print
• Send fan mail to authors

Thanks to all authors for creating a page that has been read 1,076,469 times.

Uses, Side Effects, Warnings & Interactions

Promethazine, initially developed in France in the 1940s, was approved for use in the U.S. in 1951. The drug is not only used in the treatment of allergic reactions, such as hay fever, but it can also be used as a sedative, to prevent motion sickness, and to treat nausea and vomiting (including morning sickness).

A year after it entered the U.S. market, a combination drug of promethazine hydrochloride and codeine (a prescription narcotic) was introduced for common-cold symptoms and cough. However, the substance has also been misused as a potentially dangerous illegal street drug called “drank” or “sizzurp.”

Promethazine can be administered orally as a tablet, through the rectum as a suppository and intravenously by injection

Promethazine can be administered orally as a tablet or in liquid form, through the rectum as a suppository, and intravenously by injection. If promethazine is given intravenously without proper caution, it is possible for the drug to move out of the blood vessels and into the surrounding tissue (a process called extravasation). This may cause potentially irreversible damage to tissues such as the skin, including gangrene (a dangerous, potentially fatal condition that involves the loss of blood flow to an area of tissue, causing it to break down and die). Instead, promethazine should be given by intramuscular injection.

This risk for extravasation prompted a boxed warning (the most serious drug labeling warning) from the U.S. Food and Drug Administration in late 2009. This was the second boxed warning for promethazine, with the first being required in 2006 after the FDA received reports of fatal respiratory depression (inadequate ventilation or increased concentrations of carbon dioxide) in children.

These severe, potentially life-threatening side effects are rare. More common and less severe side effects of promethazine commonly include drowsiness, dizziness, and dry mouth.

What Does Promethazine Treat?

Promethazine can relieve symptoms of allergic reactions when used as an antihistamine.

Promethazine helps relieve the symptoms of allergic reactions such as:

• Allergic rhinitis (runny nose and watery eyes)
• Allergic conjunctivitis (red, watery eyes)
• Allergic skin reactions (rash, hives)
• Allergic reactions to blood or plasma products

It can also be used in combination with other medications, such as epinephrine, to treat anaphylaxis (a sudden, severe allergic reaction) once the condition is controlled, as well as in combination with codeine for symptoms of the common cold, such as cough.

Although primarily used to treat allergies, promethazine is indicated to treat a variety of other conditions as well.

Promethazine can also be used for the following conditions:

• Sedation, to calm and to produce a light sleep in patients, before and after surgery, during labor and at other times
• To prevent and to treat motion sickness
• To prevent and to control nausea and vomiting associated with certain types of anesthesia and post-surgery
• In combination with analgesics (painkillers) to help control pain after surgery
• Intravenously in special surgical situations

How Does Promethazine Work?

Promethazine is used as a histamine-receptor blocker. Histamine receptors are proteins that bind with histamine to produce allergic reactions. This makes promethazine an effective antihistamine. The drug also blocks acetylcholine receptors, making it useful to prevent and treat nausea, morning sickness and cough. Promethazine can only help control symptoms. It isn’t effective in treating the cause of symptoms or in speeding recovery, according to the National Institutes of Health (NIH).

Promethazine Side Effects

Promethazine can cause many different side effects, some common and some serious. These side effects can affect several different body systems and organs including the brain, heart, skin, blood, stomach and intestines and lungs.

The two most serious side effects of promethazine are addressed in a boxed warning on the drug’s labeling. These reactions include respiratory depression, which can be fatal (occurring primarily in children under the age of 2 years) and, when promethazine is given intravenously, severe chemical irritation and tissue damage, including gangrene.

Common promethazine side effects:

• Drowsiness
• Difficulty falling asleep or staying asleep
• Dry mouth
• Nightmares
• Dizziness
• Blurred or double vision
• Vomiting

Serious promethazine side effects:

• Slowed breathing
• Fast or irregular pulse or heartbeat
• Abnormal or uncontrollable movements
• Hallucinations (seeing things or hearing voices that do not exist)
• Confusion
• Overwhelming or unmanageable fear or emotion
• Seizures
• Unusual bruising or bleeding
• Uncontrolled eye movements

Promethazine’s Black Box Warnings

Promethazine hydrochloride-containing products administered by injection contain two boxed warnings. A boxed warning is the most serious type of warning issued by the FDA for drugs and medical devices, meaning that the side effects can cause serious injury and possibly death.

The first boxed warning for promethazine was added in late 2004. Serious and sometimes fatal adverse events, including respiratory depression, oversedation, agitation, hallucinations, seizures, and dystonic reactions or movement disorders, have been reported in children, according to the New England Journal of Medicine (NEJM).

Black box warning label for the promethazine drug Phenergan

In 1995, the American Academy of Pediatrics took steps to discourage the use of promethazine as an anesthetic premedication in children when used with other drugs that may cause respiratory depression.

In 2000, the warnings section of the label was strengthened to recommend that promethazine not be used in children younger than 2 years of age, and that it be used with caution in older children.

However, the FDA continued to receive adverse event reports, including fatal respiratory depression in young children, most of whom were under 2 years of age. Serious outcomes, including death, disability, life-threatening events, and hospitalization, occurred with all routes of administration, whether oral, rectal or intravenous injection.

“The unpredictable nature of adverse events and their serious outcomes justified further strengthening of warnings and contraindications and the addition of a boxed warning for the use of promethazine in children.”

The boxed warning now clearly reads that promethazine hydrochloride injections should not be used in pediatric patients less than 2 years of age because of the potential for fatal respiratory depression. It also advises caution should be exercised when administering the drug in the form of an injection to patients 2 years and older.

In 2006, an FDA alert advised all health care professionals that the warning extended to promethazine hydrochloride (including brand name Phenergan and generic versions of the drug) in any form, whether syrups, suppositories, tablets or injectables.

Promethazine’s Risk of Tissue Injury

In 2009, the FDA required a second boxed warning for promethazine hydrochloride injection to warn patients of the risks of severe tissue injury with injectable administration, including gangrene and necrosis (death of a body tissue when there is not enough blood flow to the tissue).

Did You Know

The FDA advised manufacturers to include in the boxed warning that the preferred route of administration for injectable promethazine is directly into a muscle.

Because of the risk for tissue injury with administering injectable promethazine both intravenously and subcutaneously (into the layer of skin directly below the dermis and epidermis), the FDA advised manufacturers to include in the boxed warning that the preferred route of administration for injectable promethazine is deep intramuscular injection (directly into a muscle).

Promethazine should not be given by intra-arterial injection (within an artery) under any circumstances because it may cause severe arteriospasm (spasm in an artery) and result in gangrene. In fact, the Institute for Safe Medication Practices now recommends that injectable promethazine should be eliminated from hospital use.

Purple Drank SIzzurp

The misuse of a liquid syrup combination of promethazine hydrochloride and codeine (an opioid pain reliever), indicated to treat common cold symptoms and cough, has become “increasingly popular among youth in several areas of the country,” according to the National Institute on Drug Abuse. The syrup may be mixed with alcohol or flavored sodas and consumed for its mind-altering or mood-boosting effects, and may be referred to as “purple drank” or “sizzurp”.

The prescription cough syrup has been known to sell on the streets for upwards of $1,000, with one brand (that the company stopped distributing in 2014) selling for as much as $3,000, Bloomberg said in 2017.

The prescription cough syrup is also known as “purple drank”

“It’s the caviar of drugs,” said Ronald Peters, a retired professor of behavioral sciences at the University of Texas Health Science Center in Houston.

It was reported that promethazine codeine syrup was prescribed about 4 million times in the U.S. in 2016, bringing in about $15 million in sales.

The U.S. Department of Health and Human Services reported that 11,000 emergency room visits occurred in the United States in 2011 (the most recent year for which data is available) as the result of codeine misuse. The boxed warning in the label of promethazine/codeine syrup now includes a warning regarding the risk for abuse, misuse, and addiction.

How Is Promethazine Administered?

Promethazine can be administered by mouth in solid (tablet) or liquid (solution or syrup) form, by injection (intravenously or intramuscularly), or into the rectum in the form of a suppository. When taking liquid promethazine, patients should use a measuring spoon or cup made specifically for measuring medications, and not a household spoon. The suppository can only be inserted through the rectum (lower part of the large intestine through the anus), and should not be swallowed.

Prior to removing the wrapper, if a suppository feels soft, the patient should first hold it under cold, running water for one minute. After removing the wrapper, the tip of the suppository should be dipped in water prior to insertion, using the finger. In adults, the suppository should be inserted into the rectum by one inch and by about one-half to one inch in children 2 and older.

Deep intramuscular injection is the preferred method of promethazine injection

Since promethazine administered intravenously can cause severe chemical irritation and damage to tissues, deep intramuscular injection is the preferred method of injection.

Subcutaneous injection is also not advised because it may result in chemical irritation and damage to tissues, including necrosis.

Promethazine Dosages

Dosing for patients taking promethazine may vary based on the condition being treated, a patient’s age and weight, other medications that a patient may be taking and other medical conditions that they may have.

Dosages by Condition:

Allergic Conditions

The average adult dose is 25 milligrams of promethazine. The dose may be increased or decreased or given several times daily, based on symptoms.

Sedation

In hospitalized adults, 25 to 50 milligrams of promethazine injection is recommended to achieve sedation.

Nausea and Vomiting

The usual adult dose of promethazine for nausea and vomiting is 25 milligrams. When adult patients cannot swallow tablets for nausea and vomiting, promethazine suppositories may be given at a dose of 12.5 to 25 milligrams. Doses may be given every four to six hours.

The usual dose of promethazine for children with nausea and vomiting is 0.5 milligrams per pound of body weight, which may be adjusted based on age, weight, and symptoms.

Before and After Surgery

In adults, the usual dose of promethazine is 50 milligrams prior to undergoing surgical or obstetric procedures. In children, the usual dose is 0.5 milligrams per pound of body weight.

Pediatric Patients

Promethazine should not be used in children less than 2 years of age, and it should be used with caution in children older than 2 years. When given to children older than 2 years of age, the lowest effective dose should be used.

When Administered Intravenously

Promethazine can potentially interact with a number of other medications. Taking promethazine with certain medications can decrease the effectiveness of either drug or increase a patient’s risk of unwanted side effects.

Promethazine & Drug Interactions

Promethazine can potentially interact with a number of other medications. Taking promethazine with certain medications can decrease the effectiveness of either drug or increase a patient’s risk of unwanted side effects.

Medicines and other substances that may interact with promethazine include:

• Alcohol
• Acetycholinesterase inhibitor medications – used to treat dementia in patients with Alzheimer’s disease
• Anticholinergic drugs – used to treat a variety of conditions including dizziness, gastrointestinal disorders, insomnia (short-term), respiratory disorders and sinus bradycardia (a heart beat that is regular but slower than normal)
• CYP 2B6 inhibitor medications, such as Paxil (paroxetine) and Zoloft (sertraline). The effects of these drugs may be increased when taken together with promethazine.
• CYP 2D6 inhibitor medications, such as Chlorpromazine, Prozac (fluoxetine), miconazole, Paxil (paroxetine), quinidine and Norvir (ritonavir). The effects of these drugs may be increased when taken together with promethazine.
• Epinephrine (adrenaline) – a hormone, neurotransmitter (messenger in the brain) and medication
• Monoamine Oxidase Inhibitors (MAOIs) – used for the treatment of depression
• Pramlintide (Symlin) – used to treat diabetes by lowering blood sugar levels

Other medications that can cause drowsiness, such as:

• Antipsychotic medications
• Anxiety medications
• Most antidepressants
• Muscle relaxants
• Narcotic pain relievers
• Sleep medications
• Some antihistamines

Ibuprofen may be used effectively for altitude sickness: Study

Ibuprofen – the simple, widely available, over-the-counter pain reliever could help with altitude sickness.

Altitude sickness manifests by symptoms including a headache, fatigue, dizziness and sometimes nausea and vomiting. In addition, patients most likely also feel like they are working harder to breathe, like they are constantly trying to catch their breath. It normally takes days to weeks to fully acclimate to a higher altitude. It affects between 25 percent and 40 percent of the population and can be debilitating.

There are other medicines that are used to help treat altitude sickness. Dexamethasone and acetazolamide are the two most often prescribed but both have side effects that can make them tough for some to take. Having a simple medicine like ibuprofen to treat this problem can help those going to higher altitude.

Researchers publishing a study in the Annals of Emergency Medicine gave 86 low-altitude volunteers either 600 mg of ibuprofen or a placebo six hours before ascending to a higher altitude and then at six-hour intervals. 44 participants received ibuprofen and 42 got a placebo. They received doses at base camp and another at 11,700 feet. All hiked nearly three miles at altitude, after which they received a third dose. Then they spent the night and took a final dose in the morning. Their symptoms were monitored and tallied through a questionnaire. Significantly fewer of those taking the ibuprofen reported altitude sickness symptoms.

The odds of developing acute mountain sickness, or AMS, were far more likely in a placebo group than in those who took ibuprofen. Overall, 69 percent of people in the placebo group developed AMS, compared with just 43 percent in the ibuprofen group.

And symptoms of AMS were less severe in people in the ibuprofen group who did develop the illness, according to study lead author Dr. Grant Lipman of Stanford University School of Medicine. “We did this study with the mountaineer or those who have limited vacation time in mind, but it certainly has applicability to the war fighter,” Lipman said. “If you have limited vacation time, or in the case of the military, you don’t have time to prepare to go to high altitude, this potentially could be a good medicine,” Lipman said.

Ibuprofen, as with any medication, carries risk. The popular anti-inflammatory can cause upset stomach, gastrointestinal bleeding and kidney damage in those with reduced kidney function. “Ibuprofen needs to be taken with lots of fluids and food,” Lipman said. To ward off AMS, the recommended dose, according to Lipman, is 600 milligrams six hours before ascent and 600 milligrams three times on the day of travel.

Ibuprofen offers relief for many with migraine headaches — ScienceDaily

For many people suffering from migraine headaches, over-the-counter ibuprofen — Advil and Motrin are well-known brands — might be enough to relieve the pain.

A new Cochrane review finds that about half of those with migraine headaches will have pain relief within two hours after taking ibuprofen.

“We knew that many migraineurs rely on over-the-counter medication to treat attacks and surveys show that while some find them helpful, many are dissatisfied,” said review co-author Sheena Derry of the Pain Research and Nuffield Department of Anaesthetics at the University of Oxford.

Migraine headache is intense throbbing pain on one side of the head, and an attack can last anywhere between four and 72 hours. Symptoms such as nausea, vomiting, aura and increased sensitivity to light and sound often accompany migraines.

The systematic review was published by The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

According to the Migraine Research Foundation, migraine ranks in the top 20 of the world’s most disabling medical illnesses with more than 10 percent of the population, including children, suffering from the condition.

Migraine also causes less productivity at work and school. Less than 10 percent of sufferers are able to work or function normally during their migraine attacks, and American employers lose more than $13 billion each year as a result of 113 million lost work days, says the Migraine Research Foundation.

To relieve their headache pain, almost half (49 percent) of migraine sufferers use over-the-counter medication only, 20 percent use prescription medication and 29 percent use both, according to the Cochrane review.

Derry said she and her fellow reviewers conducted the Cochrane review to help provide a more definitive answer on whether ibuprofen is effective for migraine pain. They also wondered whether also taking an antiemetic to relieve nausea was better than taking an ibuprofen alone.

“We knew that there were a number of published trials using ibuprofen for acute treatment of attacks,” she said. “Individual trials, however, can be misleading for a number of reasons, and generally it is recognized that using systematic review and meta-analysis is likely to provide a more accurate estimate of the effects of any intervention.”

The reviewers evaluated nine studies with 4,373 adult participants who had a diagnosis of migraine headache. The average age of the participants was 30 to 40 years and all had a history of migraine for at least 12 months before entering the studies.

In total, 414 people with migraines underwent treatment with 200 milligrams of ibuprofen, 1,615 received a dose of 400 milligrams, 208 received a 600-milligram dose and 1,127 received a placebo.

Twenty-six percent of patients taking the 400-milligram dose were pain free within two hours, compared with 20 percent who took the smaller dose and 11 percent who received a placebo. In the same period, 57 percent who took 400 milligrams of ibuprofen had their pain reduced from moderate or severe to “no worse than mild,” compared with 25 percent taking a placebo.

“For those who experience these outcomes, ibuprofen is a useful, inexpensive and readily available treatment,” Derry said. “Those who don’t experience good outcomes will need to look at alternative treatments.”

Roger Chou, M.D., associate professor of medicine at Oregon Health & Science University and the director of clinical guidelines development at the American Pain Society, said that it is common to use OTC medications such as ibuprofen to treat migraines.

“Migraine sufferers really vary in what they do, in part because the severity and frequency varies so much,” said Chou. “People with relatively mild migraines probably do use over-the-counter medications and so do people who find that they work.”

He added, “Those with more severe migraines, or who don’t get relief with over-the-counter medications, or who have very frequent migraines, often end up in the doctor’s office and are given various prescriptions.”

Derry and her colleagues also found that the nausea and other symptoms that usually accompany migraines decreased within two hours and fewer participants used rescue medications with ibuprofen compared with placebo. Only mild side effects occurred with the ibuprofen.

The reviewers found little information comparing ibuprofen with other medications and no information comparing the effectiveness of ibuprofen combined with an antiemetic.

Two of the four reviewers disclosed previous consulting work with various pharmaceutical companies.

Ibuprofen instructions for use, price in pharmacies in Ukraine, analogues, composition, indications | Lekhim Ibuprofen

Ibuprofen – NSAID

Ibuprofen is a widely prescribed NSAID, is considered one of the safest drugs in this group and is generally well tolerated, but nevertheless can rarely cause clinically significant and severe acute liver damage. Ibuprofen has anti-inflammatory, analgesic and antipyretic effects.

The drug is prescribed for symptomatic treatment of various types of pain, including headache, toothache, dysmenorrhea, neuralgia, back pain, joint pain, muscle pain, rheumatic pain, as well as signs of SARS and influenza. Ibuprofen is prescribed as a monopreparation, or in combination with other analgesics, antihistamines or anticholinergic drugs, usually in doses of 200, 400, 600 or 800 mg. Pediatric dosage forms of this drug are also available at pharmacies.Ibuprofen is part of many combined drugs for the symptomatic treatment of dysmenorrhea, headache, allergies, ARVI.

Ibuprofen. FDA Approved Indication

Ibuprofen is indicated and approved by the FDA for the symptomatic treatment of inflammatory diseases and rheumatoid arthritis. Ibuprofen was discovered in the search for an alternative noncorticosteroid treatment for rheumatoid arthritis. This disease was the impetus for the creation of a substance that eventually became known as ibuprofen.Patented by Dr. Stuart Adams and John Nicholson as 2- (4-isobutylphenyl) propionic acid (ibuprofen) has become and remains one of the most widely used NSAIDs in the world (Halford G.M. et al., 2012). Today, ibuprofen is used as a monotherapy for the symptomatic treatment of pain in rheumatoid arthritis and inflammatory diseases, with some research being carried out in the field of introducing new treatments or dosage forms. One of these studies includes the creation of complex drugs based on NSAIDs and a carbonic anhydrase inhibitor for the symptomatic treatment of pain in rheumatoid arthritis (Akgul O. et al., 2018).

Ibuprofen is FDA approved for symptomatic use in mild to moderate pain. As an over-the-counter drug, it is used as a symptomatic treatment for muscle sprains, joint pain, migraine, sore throat, SARS / influenza. Postoperative pain is a type of pain. In one randomized, double-blind study, the therapeutic efficacy of iv ibuprofen was demonstrated, the reference drug was iv acetaminophen. The effectiveness of the drugs was compared in the treatment of postoperative pain in patients undergoing laparoscopic cholecystectomy.As a result of the study, in the first 24 hours after the procedure, it was found that with intravenous ibuprofen therapy, the severity of pain decreases and thus it is possible to reduce the dose of opioids (Ekinci M. et al., 2019). Ibuprofen is widely used as an effective drug for the symptomatic treatment of pain, but research continues to improve its clinical use.

Ibuprofen is also FDA approved as an antipyretic drug used to reduce body temperature in both adults and children. NSAIDs are much more commonly used in the treatment of fever in children, and much of the current research is focused on making ibuprofen more effective for this purpose.

Dysmenorrhea is a medical condition associated with pain during menstruation, which can vary. Dysmenorrhea can be either primary, which is usually mediated by the production of prostaglandin during ovulation, or secondary to another disease such as endometriosis or pelvic inflammatory disease (Durain D., 2004). NSAIDs are often a therapeutic choice and are approved by the FDA for the treatment of primary dysmenorrhea. Transdermal drug delivery has been a research topic in the context of the use of ibuprofen for symptomatic therapy in primary dysmenorrhea. One study examined the use of essential oils as penetration enhancers for transdermal delivery of ibuprofen in dysmenorrhea patients. A study found that one of the essential oils (Chuanxiong oil) had a positive effect on permeability and pain relief when administered with ibuprofen hydrogel (Chen J. et al., 2015).

Ibuprofen and other NSAIDs are also FDA approved for the treatment of osteoarthritis. The results of a comparative study of celecoxib (coxib group) and ibuprofen demonstrated the same tolerability and efficacy in the treatment of patients with osteoarthritis of the knee joint (Gordo A.C. et al., 2015).

The use of ibuprofen for the symptomatic treatment of gout attacks has been studied. In 1978, as a result of a study by Schweitz and co-authors, a rapid improvement and decrease in the severity of pain was recorded in 10 patients with acute gouty arthritis (patients took ibuprofen 2400 mg) (Schweitz M.C. et al., 1978). Ibuprofen is usually used as monotherapy for mild attacks, and colchicine is used as therapy for moderate to severe gout attacks.

NSAIDs and colchicine are also often used in combination in the treatment of pericarditis due to the anti-inflammatory and analgesic properties of NSAIDs. Since 2011, ibuprofen has been one of the most widely used NSAIDs in the treatment of pericarditis. Its effectiveness has been demonstrated in the CORP and CORP-2 studies in the treatment and prevention of multiple recurrences of idiopathic pericarditis compared with acetylsalicylic acid.The study did not establish a significant difference between the two drugs in the treatment or prevention of idiopathic pericarditis (Schwier N. et al., 2017). In a 2014 review, colchicine proved to be an effective drug in reducing the incidence of recurrent pericarditis when used as adjunctive therapy to NSAIDs such as ibuprofen, acetylsalicylic acid or indomethacin, but with limited number of studies (Bayes-Genis A. et al. , 2017).

IV ibuprofen has been approved by the FDA as a therapy for patent ductus arteriosus in premature infants.As a result of studies, a similar efficacy of ibuprofen with indomethacin in this pathology was recorded. Differences exist in the incidence of systemic vasoconstriction and renal toxicity; probably due to the lower selectivity for COX-1, it was found that ibuprofen had reduced rates of both outcomes (Ferguson J. M., 2019).

Since 2007, USPSTF guidelines have recommended the use of acetylsalicylic acid and NSAIDs for the prevention of colorectal cancer in certain populations.In 2016, they updated these recommendations, as well as the 2009 recommendations on the use of acetylsalicylic acid and NSAIDs in the prevention of cardiovascular diseases (Bibbins-Domingo K. et al., 2016). Although these recommendations are not specific to ibuprofen, they still provide a solid foundation for research that supports the potentially important role of NSAIDs in cancer treatment and prevention. The results of studies on the effectiveness of NSAIDs in the treatment of cancer, as well as some studies on the effectiveness of ibuprofen, have shown promising results.A review by Hil’ovska et al documented the potential use of NSAIDs in reducing the growth, morphology, and invasion of cancer cells; in the induction of cancer cell death and in the use of a lower dose of cytotoxic drugs (Hiľovská L. et al., 2015). The studies reviewed were mainly devoted to COX-2 inhibitors. With regard to ibuprofen specifically, some studies have suggested that it has a stronger antitumor effect than acetylsalicylic acid, namely in studies conducted in the treatment of breast and lung cancer (Harris R.E. et al., 2005). Also, when using ibuprofen or acetylsalicylic acid, the risk of developing breast cancer is reduced (Cuzick J. et al., 2009).

Similar to previous authors, Wawro et al. In their studies have demonstrated potential indications for the use of NSAIDs, especially acetylsalicylic acid and ibuprofen, in cancer therapy in patients with colorectal cancer who are receiving vincristine monotherapy. The putative role of NSAIDs is primarily to prevent chemoresistance by inhibiting the proliferation of cancer-related fibroblasts.Vincristine stimulates the growth of cancer-associated fibroblasts through the secretion of tumor growth factors beta (TGF-β) and IL-6; when using acetylsalicylic acid and ibuprofen, scientists have recorded the inhibitory effect of the drug on this pathological process. Their studies were based on the assumption that the probable mechanism of this inhibitory effect is associated with NSAIDs, which affect the rate of regulation of the dynamics of microtubule polymerization (Wawro M.E. et al., 2019).

Ibuprofen. Pain in the child population

Pain is a common symptom in children.For more than 30 years, the use of ibuprofen in the pediatric population has been the subject of research. The scientific literature reviewed information on childhood illnesses over the past 20 years, drawing conclusions about the efficacy and side effects associated with the use of ibuprofen as an analgesic. Ibuprofen has been shown to be effective in several pain conditions in children, such as musculoskeletal pain, earache and acute otitis media, toothache, and inflammatory diseases of the mouth and pharynx.It is a reasonable and effective alternative for postoperative pain, including tonsillectomy and adenoidectomy. It also remains the choice in the symptomatic treatment of pain in chronic inflammatory diseases such as arthritis. The side effects associated with ibuprofen are minor. It has the lowest gastrointestinal toxicity of an NSAID, although some gastrointestinal toxicity may occur. Renal side effects are minimal, but dehydration plays an important role in the development of kidney damage, so ibuprofen should not be given to patients with vomiting and diarrhea.Ibuprofen therapy has demonstrated a good safety profile and provided evidence of efficacy in the symptomatic treatment of mild to moderate pain in children of various origins. The analgesic effect of NSAIDs such as ibuprofen is mainly to inhibit prostaglandin biosynthesis. A decrease in the synthesis of prostaglandins leads to a decrease in the production of glutathione and renal perfusion.

Advantage of combined / alternating use of ibuprofen and acetaminophen

The benefits of concurrent or sequential use of NSAIDs and acetaminophen have been suggested due to their potential synergistic antinociceptive effects, as well as the convenience of using an additional anesthetic for pain that does not respond to monotherapy at any age-related dose.For acetaminophen, C _max in blood plasma is reached after 30 minutes compared to 60 minutes for ibuprofen. In studies of antipyretic effects, acetaminophen maximizes fever after 2 hours and ibuprofen after 3 hours. Recommended dosing intervals are every 6 and 8 hours for acetaminophen and ibuprofen, respectively; thus, in theory, they can alternate every 3 hours. Short-term use of an alternating dosing regimen may be considered for symptomatic treatment of pain that cannot be relieved by monotherapy (Massimo Barbagallo et al., 2019)

There are several randomized controlled trials of symptomatic treatment of headache in children. They concluded that only ibuprofen and sumatriptan were significantly more effective than placebo in reducing the severity of headache.

One Cochrane review included 27 randomized controlled pediatric studies of the effectiveness of NSAIDs. Each of them compared the therapeutic efficacy of one of the drugs in this group with a placebo.Evaluation of the effectiveness was carried out 2 hours after taking the study drug. Based on a systematic review, ibuprofen appears to be more effective, making it the drug of choice for symptomatic headache management. If you suspect a migraine, you should consider the use of NSAIDs and triptans. In case of nausea and vomiting, antiemetic drugs and IV rehydration should be performed (Raucci U., 2019).

Conclusions. Ibuprofen – NSAID safety profile

Ibuprofen first appeared on the market about 50 years ago and quickly became a popular drug.In April 2019, the French National Agency for the Safety of Medicines and Health Products (ANSM) issued a warning on the use of NSAIDs in patients with infectious diseases, based on an analysis of 20 years of real-life data on the safety of ibuprofen and ketoprofen. Nevertheless, ibuprofen remains the basic drug used in the symptomatic treatment of pain of various origins, which is clearly confirmed in numerous randomized clinical trials and clinical experience.There is a literature review on the safety of ibuprofen and how it compares favorably with other NSAIDs. For ibuprofen therapy, adverse reactions not only from the gastrointestinal tract are characteristic, which are dose-dependent and especially characteristic of a certain population of patients. Among NSAIDs, ibuprofen has a relatively low risk of cardiovascular side effects. Overall, ibuprofen has a favorable safety profile and is effective in many acute and chronic pain conditions (Varrassi G.et al., 2020).

90,000 How pain relievers affect the body

British doctors have reported serious side effects from the popular pain reliever ibuprofen. Experts noted that it can cause dizziness, headaches, nausea, indigestion, and even pose a risk of gastrointestinal bleeding and blurred vision. But you need to be careful with any pain relievers.

Side effects of ibuprofen have been reported to the UK National Health Service.Doctors found that “more than one person” in 100 had negative symptoms after taking ibuprofen. Some had more headaches, others felt dizzy, nausea and indigestion.

But the biggest problems are the risk of gastrointestinal bleeding and visual impairment. In some cases, an allergic reaction is also possible.

The negative traits of ibuprofen have been reported before. For example, in December 2020, Dr. Alexander Myasnikov said that drugs based on ibuprofen or analgin can cause stroke, heart attack or hypertension.Especially these substances are contraindicated for people over 60 years old.

In March 2020, the World Health Organization announced the dangers of self-administration of ibuprofen in the treatment of coronavirus, noting the risks of internal bleeding.

However, medical experts warned that any substance should be treated with caution. It is best not to self-medicate, but to turn to professionals.

The key to success in the correct dosage

Pharmacist, former head of the Dalkhimpharm pharmacy chain Irina Bulygina in an interview with 360 said that all non-steroidal anti-inflammatory drugs advertised on TV have such side effects.

People who have problems with the gastrointestinal tract are not prescribed such substances. And it doesn’t matter if they are in tablets, in the form of suppositories or injections.

We have no safe medicines. Any medicine is poison, a matter of dosage and correct use. If the dosage is exceeded and the person does not know about his problems, it may end badly for him

Irina Bulygina.

To protect yourself, you need to look for your doctor, and not self-medicate.

Of course, if a person has a terrible headache, you can take a pain reliever. But after that, you should go to the doctor and find out if this headache is some kind of disease. This should be done if headaches occur regularly.

Timely treatment

An expert in the medical field, dentist Alexey Antipenko explained that if you take painkillers for a long time, the stomach first of all suffers – erosive changes or gastritis develop.

Each drug has a certain amount of time when it can be taken without the supervision of a specialist. If the patient takes the drug for a longer time, you need to go to the doctor and take blood tests to check the body.

Long-term use of painkillers can have the main side effect that the pathological process, due to the fact that the patient sat at home and endured, will go into a worse stage compared to the one with which it all began. The consequences can be much more deplorable than when it was necessary to treat

Aleksey Antipenko.

According to Antipenko, gastrointestinal bleeding, which the British doctors talked about, can develop even in the presence of a concomitant disease. At the same time, everyone has gastritis to one degree or another, Antipenko noted, because we periodically drink coffee and eat not quite the right food, even if we are trying to adhere to a healthy lifestyle.

If you take painkillers wisely, there will be no problems. But when a person has pain, he no longer thinks about the volume of taking this or that drug.And here anything can come out. According to Antipenko, analginum can also be “thrown to death”.

To say categorically that “do not drink ibuprofen, it hurts your head or something else” – no. It has a good quality, it works. <…> He very coolly knocks the temperature down for three hours

Aleksey Antipenko.

You can take pain medications for three to five days without a doctor’s supervision. Particular attention should be paid to people who have, for example, stomach problems.They should not abuse pain relievers. And then you need to contact your doctor.

Allergy sufferers also need to carefully take such drugs.

You can use the old-fashioned methods of pain relief. For example, there is a dot between the thumb and forefinger on the hand. You need to press this point and hold for 20 seconds, then release and repeat. You can also use your fingernails to squeeze the earlobe to hurt. These methods will not completely relieve the pain, but they will temporarily block it.

90,000 Migraine headaches during pregnancy: what to do

Migraine is a benign disease that does not affect pregnancy or fetal development. At the same time, migraine and pregnancy are a combination that requires a responsible attitude. Especially with frequent migraines (more than 2 times a week) and migraines with aura, since:

• approved drugs, few,

• and the approach to the treatment and prevention of migraine during this period is extremely individual: it depends on the frequency, severity and duration of the headache, the degree of influence on life.

Our neurologist Daria Korobkova conducted a live broadcast on the clinic’s Instagram account, where she told how migraines and pregnancy are connected, why attacks become more frequent or disappear, and answered questions from subscribers. The broadcast was saved, see “Recording of the broadcast: migraine during pregnancy and hepatitis B.

We will tell you separately about migraines during breastfeeding.

Statistics of clinical observations of migraine during pregnancy looks like this:

In 60-70% of pregnant women with migraine, headache attacks become less frequent, softer, or even completely disappear in the second and third trimesters.This is due to the stabilization of estrogen levels. By the beginning of the second trimester, it rises 6 times and its fluctuations stop.

In other women, migraines during pregnancy either remain unchanged or worsen. But as the gestation period increases, the proportion of such women gradually decreases:

• in the first trimester, deterioration was observed in 18% of women with migraine,

• the second is already at 12%,

• and in the 3rd – 9%.

If at the end of the first trimester the frequency and intensity of attacks persist, then it is most likely that migraine will bother the woman during the entire period of pregnancy and after childbirth too.

How to manage migraines during pregnancy?

The main thing here is to learn how to control seizures and, if necessary, seek help from a doctor.

1. Stick to lifestyle guidelines:

• get enough sleep;

• Drink plenty of fluids;

• eat fractionally and without long breaks;

• rest;

• Avoid stressful situations.This is one of the main migraine provocateurs. Here psychotherapy, relaxation and stress management can help you.

2. Keep a headache diary. This will help you take control of the migraine attackers.

Yes, adhering to these simple recommendations is sometimes enough to make attacks less frequent! Pregnancy is a special condition of a woman. If in other periods of our life we ​​do not take such recommendations so seriously, then in this situation it is worth trying to change the philosophy of life and attitude towards ourselves =)

How to relieve an attack?

1. Give preference to non-drug methods.Sometimes, in order to relieve an attack, it is enough to eliminate the unfavorable factor:

• dry biscuits, ginger or applesauce can help with nausea;

• from dehydration – diluted juice or other liquid;

• Sleeping, walking or breathing exercises can also help to cope;

• , you can use the Cefaly device, which with the help of electrical impulses relieves or relieves headaches.

2. If the attacks are severe, interfering with your life, then under the supervision of a specialist, you can resort to drug therapy.

PARACETAMOL is considered the safest, it can be taken throughout pregnancy.

All other drugs have nuances. For example:

• ibuprofen can be taken in the second trimester, and in the first trimester it is better to limit it, in the third trimester the drug is contraindicated for use;

• aspirin is prohibited in the 3rd trimester and undesirable for the first two trimester, as it can cause extremely undesirable consequences;

• it is categorically impossible to use ergotamine and opioid analgesics;

• triptans are not officially approved for use in pregnancy because no controlled studies have been conducted.However, clinical observations of women around the world taking them on their own have not demonstrated adverse effects on the fetus. We examined this issue in more detail on the air.

! In addition to paracetamol, we do not recommend the use of any drug without a doctor’s prescription.

When to see a doctor:

• migraine onset for the first time during pregnancy;

• if migraine attacks become more frequent and stronger;

• if the aura has become longer or appears for the first time;

• if the headache is rapidly onset and is unusual;

• if the pressure rises during the headache.

Subscribe to our Instagram to read the latest materials on the diagnosis and treatment of headaches!

90,000 Top 10 questions about a hangover in the New Year – answered by a chemist and toxicologist

How much to drink to avoid a hangover?

Chemist Arkady Kuramshin is sure: there is no alcohol that can be drunk with “minimal consequences”.

“Of course, that on New Year’s Eve almost no one refrains from doing this, you need to know when to stop.This is not to say which alcohol is better than another. Even if we compare it with well-refined wine, refined whiskey and others, the body will still not say “thank you” in the morning, ”said Arkady Kuramshin.

Which alcohol is healthier for the body?

It is believed that red wine is good for the heart and can maintain a stable blood pressure. But Kuramshin does not agree with this.

“Red wines can exacerbate gouty arthritis due to the dyes in the wine.A person should imagine what medical contraindications he has, ”the candidate of chemical sciences believes.

How to drink alcohol?

On the New Year’s table, alcohol coexists with juices and sweet soda. True, if you drink them together with champagne or other alcohol, you get a mixture that is harmful and even dangerous for the body, notes the chief freelance toxicologist of the Ministry of Health of the Republic of Tatarstan Aliya Nasibullina.

“Combining with sweet things is contraindicated, because first a person experiences an increase in sugars, then a decrease in sugars.If someone has diabetes, then this can also lead to disastrous consequences, for example, loss of consciousness. There is a large amount of sugar in juices and soda, so surges in blood sugar are inevitable, “Nasibullina said.

Drinking alcohol with carbonated mineral water is also not an option. Like any other carbonated drink, it only accelerates intoxication.

“Soda should not be washed down with alcohol because of gas bubbles, and, moreover, not only sweet, but also ordinary mineral water.Soda is not worth it because gas bubbles accelerate the penetration of ethyl alcohol into the blood and intoxication sets in faster, ”Arkady Kuramshin believes.

From a chemical point of view, sweet juices and soda do not counteract alcohol intoxication in any way, but they are high in sugar. This means that on New Year’s Eve, you simply consume more calories with alcohol.

Is it possible to go to the bathhouse while intoxicated?

Back in 1975, Arkady Gaidai in the immortal classic “Irony of Fate, or Enjoy Your Bath!” said that going to the bathhouse in alcoholic intoxication does not come to anything good.Years go by, but the essence does not change.

“Visiting baths and saunas is a shortcut to cardiology as a patient,” said chemist Arkady Kuramshin.

His side was supported by toxicologist Aliya Nasibullina and noted that drunkenness in a bath or sauna is much faster.

“The consequences can be disorders of the cardiovascular system, as the vessels dilate when drinking alcohol and when visiting a bath. Naturally, when there is a fact of drinking alcohol when visiting saunas, intoxication occurs much faster, so it is very difficult to control your condition and consciousness, ”Nasibullina noted.

Can alcohol and antibiotics be combined?

Liver damage and kidney problems are guaranteed to the daredevil who decides to combine alcohol and antibiotics. Both of our experts agreed on this.

“If we are talking about the combined use of a course of antibiotics and alcohol, then there may be disastrous consequences from the liver – acute liver failure, but also renal failure. This is a serious condition that leads to irreversible consequences, ”said the freelance toxicologist of the Ministry of Health of the Republic of Tatarstan.

She added that alcoholic beverages are generally contraindicated for people who drink medications for chronic diseases of the cardiovascular system.

“The effectiveness of antibiotics in this combination [with alcohol] is not lost. The fact is that antibiotics in many ways affect the liver as molecules alien to our body, and the combined effect of ethyl alcohol and antibiotics creates a more massive blow to liver cells, possibly toxic damage, “said chemist Kuramshin.

Hangover medication?

If you still “went over” on New Year’s Eve, you should not look for a miraculous pill that will relieve hangover symptoms at once. In this case, medications will only increase the load on the body, so drinking handfuls of paracetamol or ibuprofen for headaches is useless and simply harmful, experts say.

“Paracetamol and ibuprofen are the first choice drugs for inflammatory diseases or ARVI. Aspirin yes [can be taken], but for those with stomach problems, increased use of aspirin can exacerbate ulcers or gastritis, ”said the toxicologist.

Chemist Arkady Kuramshin agrees with her, who insists: in a hangover, when a head hurts, it is not recommended to use pain relievers: neither paracetamol, nor ibuprofen, nor other things.

“Medicines are already a toxin, in fact, which the liver must process. There is, of course, something that can relieve a headache or something else, but in fact, all this painful condition goes away by itself after the removal of all metabolic products of ethyl alcohol from the body, “Kuramshin emphasized.

Activated carbon is also not an aid in the fight against a hangover.

“Activated carbon is meaningless here because we have a hangover condition due to the accumulation of acetaldehyde, this is a small molecule, it is not absorbed by activated carbon,” Kuramshin explained from the point of view of chemistry.

Does pickle drink hangover?

A person drinking pickle for a hangover is more of an anecdote, but according to experts, every joke is just a fraction of a joke.The hangover remedy, which has taken root among the people since the days of Ancient Russia, can really help.

“ When the body processes ethanol, it loses water greatly and its electrolyte balance changes. Ordinary water, into which we throw table salt, can help. Since it is tasteless, all sorts of spices – garlic, dill, which are contained in the brine, help to take it inside, make it not so disgusting, ”explained the popularizer of Chemistry Arkady Kuramshin.

Toxicologist Aliya Nasibullina agrees with him: “The brine is justified, as it relieves hangover syndromes, but only if it is a brine without the addition of vinegar.”

What can you eat with a hangover?

Hangovers are associated not only with headaches, but also with nausea. As a rule, in such a state, one does not feel like eating at all, but chemist Arkady Kuramshin insists on eating.

“Food is obligatory because energy is wasted on processing. Low-fat food is suitable. You need carbohydrates, not sugar, not sweet candies. Something like cereals, pasta, ”said the chemist.

He also recommends avoiding drinks containing caffeine: strong coffee, strong tea.Better to brew herbal tea.

“I am in favor of not drinking alcohol, but since this is happening, then the dishes should not be spicy, too fatty. Better dishes with a predominance of vegetables or meat. By drinking alcohol, we already provoke the liver and pancreas to malfunction, and if we add spicy and fatty foods to it, various exacerbations can occur, ”the freelance toxicologist of the Ministry of Health of the Republic of Tatarstan is sure.

Can you have a hangover if it’s really bad?

It is believed that a hangover is easier to endure by drinking low alcohol drinks such as beer.The Ministry of Health of the Republic of Tatarstan urges not to do this.

“In no case should you alleviate your hangover condition by further drinking alcoholic beverages. This threatens the state of binge. Drinking alcohol for more than a day disrupts the state of all our organs and systems, ”stressed the chief freelance toxicologist of the Ministry of Health of the Republic of Tatarstan Aliya Nasibullina.

How to deal with a hangover at home?

Chemist Arkady Kuramshin insists that there are no secrets of fighting a hangover.His main advice is to drink more water and take a walk down the street.

“Moderate physical activity is indicated. It is clear that it is not in the gym to pull a 100-kilogram barbell, this is also contraindicated. Just take a walk with the dog, look at the New Year’s lights, ”he said.

The chief freelance toxicologist of the Ministry of Health of the Republic of Tatarstan agrees with him, who also advises to take a walk after New Year’s Eve.

“A set of measures is envisaged: walks, an increase in the amount of water drunk – about 2.5 liters of liquid and adherence to a diet after drinking alcohol,” Nasibulinna said.The toxicologist notes that, especially on New Year’s holidays, a lot of people with alcohol intoxication enter, but, fortunately, almost all patients can be saved.

Self-medication as a hobby

Before you take a pill, think about it: do you need it?

– There are no safe medicines. A medicine is not just a product or just a commodity, it can be harmful to health. The version that there are effective and absolutely safe drugs must be forgotten forever.Medicines eliminate some problems, but they will not make you healthy, – believes Associate Professor of the Department of Clinical Pharmacology of the Belarusian State Medical University, chief freelance specialist of the Ministry of Health of Belarus on clinical pharmacology Larisa Gavrilenko.

A case from the life: a woman has stomach bleeding. Frightened relatives called an ambulance, suggesting the worst thing – oncology. At the hospital, the patient was examined. It turned out that the bleeding was caused by improper use of regular aspirin.

What drugs are now in special demand among the population and how can their uncontrolled intake result?

– Among domestic drugs in the list of sales leaders (by the number of packages): citramon, analgin, corvalol, validol, activated carbon, and for the money raised – lysitar-LF, tri-zidine M, mucosat, enalapril, – said at the event in Minsk Republican scientific and practical seminar “Medicines of the Republic of Belarus” Associate Professor of the Department of Clinical Pharmacology of the Belarusian State Medical University, chief freelance specialist of the Ministry of Health of the Republic of Belarus on clinical pharmacology Larisa Gavrilenko.

– Of the imported drugs, Actovegin, Diabeton, Cardiomagnyl, Teraflu have the highest rating.

So, details about some of these drugs.

Citramon

Tablets for the treatment of headaches and colds. The drug is available in almost every home, sold without a prescription. Efficiency and low cost made it popular. However, you will not find instructions for it. The medicine is sold in blisters or paper contour packages, annotation is not attached.The drug consists of acetylsalicylic acid (better known as aspirin), paracetamol and caffeine. Most patients tolerate it well, but hypersensitivity to one of the ingredients can lead to the development of allergic reactions (itching, rash, hives). Due to the presence of acetylsalicylic acid, doctors do not recommend giving it to children under 15 years of age. The drug is contraindicated in those suffering from stomach or intestinal ulcers, ischemic heart disease, insomnia, glaucoma, as well as people with high blood pressure, impaired renal function, while breastfeeding.

Analgin

Anesthetic and antipyretic agent. The active ingredient is sodium metamizole. The subject of controversy is the side effects of the drug, and above all the risk of developing agranulocytosis against the background of its administration – a condition in which the content of neutrophilic granulocytes in the blood significantly decreases. Because of which, a person can very quickly develop severe weakness and death.

Metamizole is banned (or its use is limited) in Australia, Great Britain, Denmark, Israel, Iran, Italy, Norway, United Arab Emirates, USA, Saudi Arabia, Sweden.In a number of countries, metamizole and preparations with its content have been completely withdrawn from circulation, in others they are prohibited for use by children and adolescents, and thirdly, they are allowed only in certain situations, for example, for short-term use when other means are ineffective.

Metamizole is sold over the counter in Eastern Europe and Latin America and is considered a safe analgesic.

Clinical studies of the efficacy and safety of metamizole, including in comparison with other non-narcotic analgesics, are ongoing.

Another common mistake people make when taking pain relievers is trying to improve the effectiveness of one drug by taking another. Under no circumstances should you take several different types of pain relievers at the same time!

Corvalol

Traditional medicine. For it, however, like for valocordin, even healthy people grab onto it when, in a state of stress, they complain of a rapid heartbeat and heaviness in the chest area.The drugs soothe the nervous system, are the same in composition and properties. They include valerian extract, hop tincture, hawthorn and rhubarb tincture, sodium barbital, ethyl alcohol and distilled water.

But if your heart palpitations are not related to stress, these medications will not help. The same Corvalol is not as safe as it might seem: one of the constituents of the drug – phenobarbital – is not strong, but still hypnotic. Misuse of the medicine can be fatal.In addition, over time, a person gets used to the drug, becomes addicted.

Validol

The drug is a 25% solution of menthol (obtained from peppermint leaves) in isovaleric acid methyl ester (from valerian root).

Who can take validol and how can it be dangerous?

Validol will help with heart pains of a neurotic nature, to relieve nervous tension, to relieve headaches after taking nitroglycerin.The drug will relieve nausea and vomiting if you are seasick in transport.

Validol can be harmful if used incorrectly. In no case should you remove the attacks of angina pectoris with validol. The medicine cannot relieve the spasm of the vessels that feed the heart muscle. Time will be lost, and myocardial infarction may develop. Therefore, in case of angina pectoris, attacks should be removed only with the drug prescribed by the doctor (most often it is nitroglycerin), and validol can only be used in combination with it as a sedative.

The drug has almost no contraindications. It should not be used for hypotension. Patients with diabetes should take validol not in tablets, since it contains sugar, but in capsules or drops.

Activated carbon

Used mainly as a sorbent for poisoning.

Contraindicated in gastric ulcer and duodenal ulcer, as well as if intestinal bleeding is suspected.

It should be borne in mind that activated carbon absorbs all substances indiscriminately – both harmful and useful.If you get carried away with it, it will significantly weaken or nullify the effectiveness of the necessary medications prescribed by the doctor for treatment (antibiotics, vitamins, hormonal agents). The constant intake of this sorbent can lead to hypovitaminosis, disruption of the normal absorption of fats, proteins, vitamins and other nutrients from the gastrointestinal tract, and the development of chronic constipation. So use activated charcoal only as an ambulance and only take it for a few days.

Taking activated charcoal simultaneously with oral contraceptives reduces the effectiveness of the latter.

Cardiomagnyl

Can be purchased without a prescription, but it is in your best interest to consult a doctor.

A means of primary prevention of cardiovascular diseases such as thrombosis and acute heart failure in the presence of risk factors (diabetes mellitus, hyperlipidemia, arterial hypertension, obesity, smoking, old age).It is also used to prevent recurrent myocardial infarction and blood vessel thrombosis, thromboembolism (after coronary artery bypass grafting). The composition contains acetylsalicylic acid, we mentioned it. With the drug, jokes are bad: in case of an overdose, nausea, vomiting, tinnitus, hearing impairment, dizziness, confusion appear. In severe cases, fever, coma, cardiovascular and respiratory failure.

Teraflu

Combined remedy not for treatment, as many hope, but for eliminating the symptoms of acute respiratory infections, colds, flu.The active ingredient is paracetamol.

… In one speech, Associate Professor Larisa Gavrilenko said about self-medication that it implies a person’s care and responsibility for their health. He must lead a healthy lifestyle and use a minimum of medication. At the same time, the pharmacist, having learned about the symptoms of the visitor’s illness, is responsible for the drug that he advises to purchase. He also needs to know when the patient should be sent to the doctor immediately.

90,000 Why think twice before drinking valerian?

Valerian is the most common sedative.It is of plant origin, which is why many people do not treat it as a medicine. Why is valerian dangerous for humans?
Valerian is most often prescribed as a mild sedative. It will be useful for sleeping problems, reducing emotional stress and feelings of anxiety. But the effect of this sedative on the body in most cases is underestimated by people. They do not perceive valerian as a medicine, therefore they are convinced of its harmlessness. However, long-term use of this remedy can be hazardous to health.Serious harm to the body can be caused by taking an excessive dose of valerian at a time. The fact that you should be careful with the use of valerian is also confirmed by numerous scientific studies. It has been proven that valerian can be attributed to natural antispasmodics, therefore, in many people, the work of the digestive system may be disrupted when taken. The rate at which food is digested can be slowed down, which can lead to nausea and vomiting.
Some may wonder, but valerian is not recommended for depressive conditions.The reason is that many people have had dangerous side effects after taking it. Many complained about the slowdown in the reaction rate and even the onset of stupor. With depression, taking valerian can significantly increase the depression of the nervous system, and therefore, the patient will plunge into his state even more.
Studies show, among other things, that prolonged use of valerian leads to high blood pressure, frequent headaches, unreasonable feelings of anxiety, and sleep problems.Strange sensations and a deterioration in the general condition may indicate that the person has exceeded the permissible rate of this sedative. In such situations, the only solution may be a gastric lavage procedure.

90,000 Common unpleasant disease in women

2020.11.02

Cystitis

Cystitis is an inflammation of the bladder that is most often caused by a bladder infection, which worries women more often than men.In milder cases, symptoms and inflammation go away on their own within a few days, but some people have recurring episodes of cystitis and need regular, long-term treatment.
In some cases, cystitis can lead to a more serious kidney infection, so if symptoms do not improve within a few days, you should see your doctor.

Signs and symptoms of cystitis
The most common symptoms of cystitis:
• pain, burning or tingling sensation when urinating
• need to urinate more often and faster than usual
• dark, cloudy or foul-smelling urine
• pain in the lower abdomen
• general malaise, pain, nausea and fatigue

When to see a family doctor?
Women with cystitis do not need to urgently consult a family doctor, as in mild cases, cysts improve and go away on their own without treatment.Try self-help products or ask your pharmacist for advice.

For starters, you can try:
• take paracetamol or ibuprofen
• Drink plenty of water
• Keep your bladder with hot water on your stomach or between your thighs.
• Avoid Sex
• urinate frequently
• When going to the toilet, wipe it from front to back.
• Gently wash the area around the genitals with a skin-sensitive soap.

Some people believe that cranberry drinks and uric acid depressants are helpful, but there is insufficient evidence to support them.

Contact your family doctor if:
• you are not sure if you have cystitis
• symptoms do not improve within 3 days
• you often have cystitis
• you notice severe, more serious symptoms such as blood in your urine, fever, or pain in your side
• you are pregnant and have symptoms of cystitis

Usually, your doctor can easily diagnose cystitis; already during the examination, he can analyze your urine for bacteria, which will help confirm the diagnosis.

What causes cystitis?
In most cases, cystitis is thought to be caused by bacteria that live harmlessly in the intestines or on the skin and enter the bladder through the urethra (urethra).
How this happens is not always clear, but certain circumstances may increase the risk of developing cystitis:

• intercourse
• Poor hygiene habits.
• bladder catheterization (during medical procedures)
• age (more common in people younger than 1 year old and older than 75 years old)
• pregnancy
• using a diaphragm for contraception
• Diabetes
• Weakened immune system.

Women get cystitis more often than men because their anus is closer to the urethra. The urethra in women is much shorter, which means that bacteria can more easily enter the bladder.

General practitioners can usually easily diagnose cystitis and prescribe a course of antibiotics to treat the infection. The beneficial effect is usually achieved within one to two days. Sometimes a long course of antibiotic treatment is prescribed.

Prevention of cystitis

If you have frequent cystitis, here are some tips to help you reduce your chances of recurrence:

• Do not use scented bath foam, soap or talcum powder on the genital area.
• take a shower instead of a bath (this avoids overexposure to chemicals in cosmetic cleaners)
• use the toilet as soon as you feel the urge to urinate and always try to empty your bladder completely
• Drink plenty of fluids (drinking plenty of fluids can stop the growth of bacteria in the bladder).
• Always go to the toilet from front to back.
• It is advisable to urinate immediately after intercourse.
• Do not use a diaphragm for contraception (it is better to use another method of contraception instead).
• Wear cotton underwear instead of synthetics, and do not wear skinny jeans or trousers.
Traditionally, drinking cranberry juice is recommended as a remedy to reduce the chances of cystitis, but studies have shown that it has no significant effect.