How frequently can a patient take RELPAX®?
In controlled clinical trials of adult patients (18-65 years of age), single doses of 20 mg, 40 mg and 80 mg were effective for the acute treatment of migraine. A greater proportion of patients had a response following a 40 mg or 80 mg dose than following a 20 mg dose. The recommended initial dose is 40 mg. The maximum single dose is 80 mg.
If the initial dose is ineffective, controlled clinical trials have not shown a benefit of a second dose to treat the same attack. However, if the headache returns following initial improvement, there is evidence to suggest that a repeat dose may be beneficial. If a second dose is required, it should not be taken within 2 hours of the initial dose.
The maximum daily dose should not exceed 160 mg. No information is available on the maximum weekly or monthly usage of Relpax.
Excessive use of any anti-migraine medicinal product can lead to daily chronic headaches.
Many experts limit acute therapy to two headache days per week on a regular basis. The German Migraine and Headache Society (DMKG) guideline recommends that triptans are not to be used more than ten days per month, and/or more than on 3 consecutive days. Various other guidelines on the management of migraine have been published.
2. Silberstein SD. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2000;55(6):754-62.
3. DMKG Therapy recommendations available at http://www.dmkg.de.
4. Olesen J, Bousser MG, Diener HC, et al on behalf of the International Headache Society. The International Classification of Headache Disorders, 3rd Edition (beta version) of criteria for 8.2 Medication-overuse headache. Cephalalgia. 2013;33(9):733-5.
5. British Association for the Study of Headache (BASH) Management Guidelines 2010. Available at http://www.bash.org.uk/.
6. Agence Nationale d’Accréditation et d’Evaluation en Santé (ANAES) Chronic Daily Headache Guidelines 2004. Available at http://www.has-sante.fr/portail/upload/docs/application/pdf/CCQ_guidelines.pdf.
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