Isometheptene Mucate/Dichloralphenazone/Acetaminophen

Pronunciation: (eye-so-meth-EPP-teen MYOO-kate/die-klor-uhl-FEN-uh-zone/ASS-et-ah-MEE-noe-fen)Class: Migraine combination

Trade Names:Epidrin- Capsules 65 mg isometheptene mucate, 100 mg dichloralphenazone, 325 mg APAP

Trade Names:Midrin- Capsules 65 mg isometheptene mucate, 100 mg dichloralphenazone, 325 mg APAP

Trade Names:Migratine- Capsules 65 mg isometheptene mucate, 100 mg dichloralphenazone, 325 mg APAP


Isometheptene mucate acts as sympathomimetic to constrict dilated cranial and cerebral arterioles. Dichloralphenazone is a mild sedative that reduces emotional reaction to pain of vascular and tension headaches. Acetaminophen is a mild analgesic.

Indications and Usage

Relief of tension and vascular headaches. FDA has classified drug as possibly effective in treatment of migraine headaches.


Glaucoma; severe cases of renal disease; hypertension; organic heart disease; hepatic disease; MAOI therapy.

Dosage and Administration

Migraine HeadacheAdults

PO 2 capsules at once, followed by 1 capsule every h until headache is relieved (max, 5 capsules in 12 h period).

Tension HeadacheAdults

PO 1 to 2 capsules every 4 h (max, 8 capsules/day).

General Advice

  • Administer at first sign of migraine headache.
  • Administer with full glass of water.


Store at room temperature in dry place in tightly closed container.

Drug Interactions


May result in severe headache, hypertension, hyperpyrexia, and possible hypertensive crisis.

Laboratory Test Interactions

None well documented.

Adverse Reactions


Transient dizziness or drowsiness.





Pregnancy category undetermined.




Safety and efficacy not established.

Special Risk Patients

Observe caution in patients with hypertension or peripheral vascular disease and after recent CV attacks.


Can occur with chronic ingestion of acetaminophen. Chronic alcohol abusers are especially at risk.



Nausea; vomiting; drowsiness; confusion; liver tenderness; low or high BP; cardiac arrhythmias; jaundice; acute hepatic and renal failure.

Patient Information

  • Instruct patient to take drug at first sign of impending headache.
  • Encourage patient to rest in quiet, dark room after taking drug.
  • Advise patient not to drink alcoholic beverages.
  • Instruct patient to notify health care provider of dizziness or skin rash.
  • Instruct patient to notify health care provider if headache persists.

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