Premig

lysine acetylsalicylate & metoclopramide

Premig is a medicine which is used in treatment of migraine attacks.

This medicine contains two active ingredients, lysine acetylsalicylate and metoclopramide. Lysine acetylsalicylate is a soluble form of acetylsalicyclic acid, a painkiller, otherwise known as aspirin. Metoclopramide is an anti sickness medicine (antiemetic).

Aspirin belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). It works by blocking the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is involved in the production of various chemicals in the body, some of which are known as prostaglandins. Prostaglandins are produced in response to injury or certain diseases and can cause pain, swelling and inflammation. By blocking the production of prostaglandins aspirin therefore relieves pain and inflammation, and is effective at relieving the pain of headaches and migraines.

During a migraine attack sufferers can often feel sick or vomit. Metoclopramide is used to treat this symptom of the migraine and thus helps to speed the absorbtion of aspirin and relief of the headache more quickly.

Metoclopramide works primarily by blocking dopamine receptors that are found in an area of the brain known as the chemoreceptor trigger zone (CTZ). The CTZ sends messages to another area of the brain, known as the vomiting centre, which in turn sends nerve messages to the gut that cause vomiting. By blocking dopamine receptors in the CTZ, metoclopramide prevents messages from being sent to the vomiting centre. This reduces the sensation of nausea and prevents vomiting.

Metoclopramide also acts in the upper gut, where it enhances the action of a chemical called acetylcholine. Increasing the action of acetylcholine results in the tightening of the muscles at the entry to the stomach, as well as relaxing the muscles at the exit of the stomach. It also increases the contraction of the muscles in the stomach itself, which speeds the passage of food through the stomach into the intestine. This physically helps to prevent vomiting, but is also useful in migraine attacks because it speeds the passage of the aspirin into the intestine, allowing it to be absorbed and relieve the headache more quickly.

This combination of aspirin and metoclopramide is most effective at relieving migraine when it is taken as soon as possible after the onset of an attack.

Side effects from Premig are not common, but they can occur. One may experience drowsiness, restlessness, fatigue, constipation or diarrhea. Tell your doctor if any of unwanted symptoms are severe or do not go away.