pizotifen malate: clinical use

Prescribing considerations

• Confirm that treatment is preventive rather than intended for an established attack.
• Use caution in renal or hepatic impairment.
• Avoid abrupt withdrawal because acute withdrawal reactions have been reported.
• Consider sedative, appetite-stimulating and weak anticholinergic effects when assessing suitability.

Contraindications and cautions

• Hypersensitivity to pizotifen or any excipient
• Concurrent monoamine oxidase inhibitor treatment
• Rare hereditary galactose intolerance, total lactase deficiency or glucose-galactose malabsorption because the product contains lactose

Monitoring

• Review appetite, weight change, sedation, dizziness and functional impairment.
• Monitor clinically for hepatic dysfunction; stop and investigate if evidence of liver injury develops.
• Observe carefully in people with epilepsy, closed-angle glaucoma or a predisposition to urinary retention.

Clinical pharmacology

Pizotifen is a tricyclic compound with strong antiserotonergic and antitryptaminic activity, antihistamine effects, some kinin antagonism and weak anticholinergic activity. It is extensively hepatically metabolised, principally by glucuronidation, and metabolites are largely eliminated in urine.

Formulation and product differences

• The selected product is a white, round, film-coated oral tablet embossed “PZ”.
• It contains lactose monohydrate and is supplied in blister packaging.

Tablet

Route: Oral

Strengths: 0.5 mg, 1.5 mg