A medicine to help prevent migraine
Pizotifen
A migraine-prevention medicine taken regularly to reduce how often migraine attacks happen, rather than to treat an attack in progress.
What is Pizotifen?
Pizotifen is a medicine taken regularly to help prevent migraine attacks, not to treat an attack once it has started. It is an older antihistamine-type medicine and commonly causes drowsiness and an increased appetite that can lead to weight gain. It also has mild antimuscarinic effects, so it is used with care in glaucoma and urinary retention.
Education and reference only. This is a plain-language guide to Pizotifen — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Pizotifen is a medicine used to help prevent migraine, meaning it is taken every day to reduce how often attacks happen rather than to treat an attack that has already started. It is an older medicine related to antihistamines. It is one of the preventive options used in the UK, particularly when migraines are frequent.
How it works
Pizotifen is thought to work by blocking the action of serotonin and histamine, body chemicals involved in the changes in blood vessels and nerves that lead to migraine. By dampening these signals it helps make the brain less prone to triggering migraine attacks. Because it is taken regularly for prevention, the benefit builds up over weeks rather than working straight away.
Company & origin
Originated / developed by: A long-established migraine preventer.
An older antihistamine-type medicine used in the UK to help reduce the frequency of migraine attacks.
What it treats
Conditions Pizotifen is used for
Practical use
How to take Pizotifen
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it every day for prevention; it will not help a migraine that has already started.
- It is often taken at night, as it commonly causes drowsiness.
- Give it time, as it can take several weeks before migraines become less frequent.
- Do not stop it suddenly; your prescriber will reduce it gradually if you come off it.
- If you miss a dose, take it when you remember unless it is nearly time for the next one, then skip it and do not double up.
Weighing it up
Advantages & disadvantages of Pizotifen
Advantages
- A long-established option for reducing how often migraines happen.
- Taken as a tablet, often just at night.
- Can be helpful when migraines are frequent and other measures are not enough.
Disadvantages
- Commonly causes drowsiness and an increased appetite that can lead to weight gain.
- Has mild antimuscarinic effects, so is used with care in glaucoma and urinary retention.
- Takes weeks to work and does not help an attack in progress.
Practical use
Good to know
Pizotifen is a preventer, so it must be taken every day and does not help an attack already under way. The two most noticeable effects are drowsiness, which is why it is often taken at night, and an increased appetite that can lead to weight gain. Because it has mild antimuscarinic (drying) effects, it is used with care in people with glaucoma or difficulty passing urine. It can take several weeks of regular use before any reduction in migraines is seen, and it should not be stopped suddenly.
Who should not take it / use with caution
- People with closed-angle glaucoma or difficulty passing urine should use it with caution because of its antimuscarinic effects.
- Used with caution in people who must avoid weight gain or daytime drowsiness, such as some drivers.
- Used with caution in pregnancy and breastfeeding; discuss with your prescriber.
Monitoring
- Whether the number of migraine attacks falls over several weeks of regular use.
- Weight and appetite, as gain is common.
- Any troublesome drowsiness or antimuscarinic effects such as blurred vision or difficulty passing urine.
Side effects
- Drowsiness is common, which is why it is often taken at night.
- Increased appetite and weight gain are well-recognised effects.
- Antimuscarinic effects such as dry mouth, constipation or blurred vision, and occasionally dizziness or nausea.
Key interactions
- Extra drowsiness is possible with alcohol or other sedating medicines.
- Its drying effects add up with other antimuscarinic medicines, such as some bladder and older allergy treatments.
- Tell your pharmacist about everything you take, including over-the-counter and herbal products.
Available as: Tablets; also an oral liquid (elixir).
Answers
Pizotifen: frequently asked questions
Does pizotifen stop a migraine once it starts?
No. It is a preventer, taken every day to reduce how often migraines happen. It does not treat an attack that has already started; for that you would use an acute treatment.
Why does it cause weight gain?
Pizotifen commonly increases appetite, which can lead to eating more and gaining weight. Being aware of this and watching your diet can help.
Why is it taken at night?
It commonly causes drowsiness, so taking it at night means the sleepiness is less of a problem during the day.
How long before it helps?
It can take several weeks of taking it every day before migraines become less frequent, so it is worth persevering unless side effects are a problem.
Can I just stop taking it?
Do not stop it suddenly. If you are coming off it, your prescriber will usually reduce the dose gradually.
The wider class
About Migraine-prevention medicines
Pizotifen belongs to the migraine-prevention medicines class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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