• Migrales indications
• Uses of Migrales in details
• Migrales description
• Migrales dosage
• Migrales interactions
• Migrales side effects
• Migrales contraindications

What is Migrales?

Migrales is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure may reduce the risk of stroke and heart attacks.

Migrales is also used to treat severe chest pain (angina), migraine headaches, or hypertrophic subaortic stenosis (thickened heart muscle).

Migrales may also be used to treat irregular heartbeats, tremors, or pheochromocytoma (adrenal gland tumor). It may also be used to reduce the risk of death in patients who have heart attacks.

Migrales oral solution is used to treat proliferating infantile hemangioma.

Migrales is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.

Migrales is available only with your doctor's prescription.

Migrales indications

Hypertension

Migrales is indicated in the management of hypertension. It may be used alone or used in combination with other antihypertensive agents, particularly a thiazide diuretic. Migrales is not indicated in the management of hypertensive emergencies.

Angina Pectoris Due to Coronary Atherosclerosis

Migrales is indicated to decrease angina frequency and increase exercise tolerance in patients with angina pectoris.

Atrial Fibrillation

Migrales is indicated to control ventricular rate in patients with atrial fibrillation and a rapid ventricular response.

Myocardial Infarction

Migrales is indicated to reduce cardiovascular mortality in patients who have survived the acute phase of myocardial infarction and are clinically stable.

Migraine

Migrales is indicated for the prophylaxis of common migraine headache. The efficacy of Migrales in the treatment of a migraine attack that has started has not been established, and Migrales is not indicated for such use.

Essential Tremor

Migrales is indicated in the management of familial or hereditary essential tremor. Familial or essential tremor consists of involuntary, rhythmic, oscillatory movements, usually limited to the upper limbs. It is absent at rest, but occurs when the limb is held in a fixed posture or position against gravity and during active movement. Migrales causes a reduction in the tremor amplitude, but not in the tremor frequency. Migrales is not indicated for the treatment of tremor associated with Parkinsonism.

Hypertrophic Subaortic Stenosis

Migrales improves NYHA functional class in symptomatic patients with hypertrophic subaortic stenosis.

Pheochromocytoma

Migrales is indicated as an adjunct to alpha-adrenergic blockade to control blood pressure and reduce symptoms of catecholamine-secreting tumors.

How should I use Migrales?

Use Migrales solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Migrales solution comes with extra patient information sheets called a Medication Guide and Instructions for Use. Read them carefully. Read them again each time you get Migrales solution refilled.
• Do NOT shake Migrales solution before use.
• Use the syringe that comes with Migrales solution to measure the dose. Ask the pharmacist for help if you are unsure of how to measure the dose.
• Give Migrales solution right into your child's mouth. If needed, Migrales solution may be mixed in a small amount of milk or fruit juice and given in a baby's bottle.
• Give Migrales solution with or right after a feeding.
• Give doses of Migrales solution at least 9 hours apart.
• The dose of Migrales solution may need to be changed as your child's weight changes. Have your child's weight checked often. Talk with the doctor before changing your child's dose.
• Give Migrales solution on a regular schedule to get the most benefit from it. Giving Migrales solution at the same time each day will help you remember to give it.
• If your child spits up a dose or if you are not sure your child got all of the medicine, do not give another dose. Wait until the next scheduled dose.
• If you miss giving your child a dose of Migrales solution, give it as soon as possible. If it is almost time for the next dose, skip giving the missed dose and go back to your child's regular dosing schedule. Do not give 2 doses at once.

Ask your health care provider any questions you may have about how to use Migrales solution.

Uses of Migrales in details

Use: Labeled Indications

Angina, chronic stable: To decrease angina frequency and increase exercise tolerance in patients with angina pectoris.

Cardiac arrhythmias: Control of supraventricular arrhythmias (eg, atrial fibrillation and flutter, atrioventricular nodal reentrant tachycardia) and ventricular tachycardias (eg, catecholamine-induced arrhythmias, digoxin toxicity).

Essential tremor: Management of familial or hereditary essential tremor.

Hypertension: Management of hypertension. Note: Beta-blockers are not recommended as first-line therapy (ACC/AHA [Whelton 2018]).

Migraine headache prophylaxis: Prophylaxis of common migraine headache.

Myocardial infarction, early treatment and secondary prevention: To reduce cardiovascular mortality in patients who have survived the acute phase of myocardial infarction and are clinically stable.

Obstructive hypertrophic cardiomyopathy: Symptomatic treatment of obstructive hypertrophic cardiomyopathy (formerly known as hypertrophic subaortic stenosis).

Pheochromocytoma: As an adjunct to alpha-adrenergic blockade to control blood pressure and reduce symptoms of catecholamine-secreting tumors.

Proliferating infantile hemangioma (Migrales): Treatment of proliferating infantile hemangioma requiring systemic therapy.

Off Label Uses

Akathisia, antipsychotic-induced

Data from a limited number of patients in 5 randomized, double-blind, controlled studies support the use of Migrales in antipsychotic-induced akathisia.

Based on the American Association for the Study of Liver Diseases guidelines on the management of portal hypertensive bleeding in cirrhosis and the British Society of Gastroenterology guidelines on the management of variceal hemorrhage in cirrhotic patients, use of nonselective beta-blockers, such as Migrales, is effective and recommended for primary and secondary prophylaxis of variceal hemorrhage.

Migrales description

A widely used non-cardioselective beta-adrenergic antagonist. R,S-Migrales Hydrochloride is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety.

Migrales dosage

Migrales Dosage

Generic name: Migrales HYDROCHLORIDE 80mg

Dosage form: capsule, extended release

See also:

• Migrales Tablets
• Migrales capsule, extended release

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Migrales should be administered once daily at bedtime and should be taken consistently either on an empty stomach or with food. Initiate dosing at 80 mg and titrate to 120 mg daily as needed for blood pressure control. Doses above 120 mg have no additional effects on blood pressure. The time needed for full antihypertensive response is variable, but is usually achieved within 2 to 3 weeks.

More about Migrales (Migrales)

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Consumer resources

• Migrales
• Migrales (Advanced Reading)

• Other brands: Migrales, Migrales, InnoPran XL, Migrales

Professional resources

• Migrales (FDA)
• Migrales Hydrochloride (AHFS Monograph)

Related treatment guides

• Atrial Fibrillation
• Ventricular Tachycardia

Migrales interactions

See also:
What other drugs will affect Migrales?

Patients receiving catecholamine-depleting drugs such as reserpine should be closely observed if Beta-Migrales HCl is administered. The added catecholamine-blocking action may produce an excessive reduction of resting sympathetic nervous activity, which may result in hypotension, marked bradycardia, vertigo, syncopal attacks, or orthostatic hypotension.

Caution should be exercised when patients receiving a beta blocker are administered a calcium-channel blocking drug, especially intravenous verapamil, for both agents may depress myocardial contractility or atrioventricular conduction. On rare occasions, the concomitant intravenous use of a beta blocker and verapamil has resulted in serious adverse reactions, especially in patients with severe cardiomyopathy, congestive heart failure, or recent myocardial infarction.

Blunting of the antihypertensive effect of beta-adrenoceptor blocking agents by nonsteroidal anti-inflammatory drugs has been reported.

Hypotension and cardiac arrest have been reported with the concomitant use of Migrales and haloperidol.

Aluminum hydroxide gel: Greatly reduces intestinal absorption of Migrales.

Ethanol: Slows the rate of absorption of Migrales.

Phenytoin, phenobarbitone: and rifampin accelerate Migrales clearance.

Chlorpromazine: When used concomitantly with Migrales, results in increased plasma levels of both drugs.

Antipyrine: and lidocaine have reduced clearance when used concomitantly with Migrales.

Thyroxine: May result in a lower than expected T₃ concentration when used concomitantly with Migrales.

Cimetidine Decreases the hepatic metabolism of Migrales, delaying elimination and incre:asing blood levels.

Theophylline: Clearance is reduced when used concomitantly with Migrales.

Migrales side effects

See also:
What are the possible side effects of Migrales?

The following serious adverse reactions are discussed in greater detail in other sections of the labeling:

• Hypoglycemia and related events, like hypoglycemic seizure.
• Bronchospasm.

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug may not reflect the rates observed in clinical practice.

Clinical Trials Experience with Migrales in Infants with proliferating infantile hemangioma

In clinical trials for proliferating infantile hemangioma, the most frequently reported adverse reactions ( > 10%) in infants treated with Migrales were sleep disorders, aggravated respiratory tract infections such as bronchitis and bronchiolitis associated with cough and fever, diarrhea, and vomiting. Adverse reactions led to treatment discontinuation in fewer than 2% of treated patients.

Overall, 479 patients in the pooled safety population were exposed to study drug in the clinical study program (456 in placebo-controlled trials). A total of 424 patients were treated with Migrales at doses 1.2 mg/kg/day or 3.4 mg/kg/day for 3 or 6 months. Of these, 63% of patients were aged 91-150 days and 37% were aged 35-90 days at randomization.

The following table lists according to the dosage the most common adverse reactions (treatment-emergent adverse events with an incidence at least 3% greater on one of the two doses than on placebo).

Table 2: Treatment-emergent adverse events occurring at least 3% more often on Migrales than on placebo.

The following adverse events have been observed during clinical studies, with an incidence of less than 1%:

Cardiac disorders: Second degree atrioventricular heart block, in a patient with underlying conduction disorder, required definitive treatment discontinuation.

Skin and subcutaneous tissue disorders: Urticaria, alopecia

Investigations: Decreased blood glucose, decreased heart rate

Compassionate Use Program

More than 600 infants received Migrales in a compassionate use program (CUP). Mean age at treatment initiation was 3.6 months. Mean dose of Migrales was 2.2 mg/kg/day and mean treatment duration was 7.1 months.

The adverse reactions reported in the CUP were similar to the ADRs observed during clinical trials but some were more severe.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of Migrales. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

These adverse reactions are as follows:

Blood and lymphatic system disorders: Agranulocytosis

Psychiatric disorders: Hallucination

Skin and subcutaneous tissues disorders: Purpura

Migrales contraindications

See also:
What is the most important information I should know about Migrales?

You should not use this medication if you are allergic to Migrales, if you have asthma, a slow heart rate, or a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker).

If you need surgery, tell the surgeon ahead of time that you are using Migrales. You may need to stop using the medicine for a short time.

Do not skip doses or stop using Migrales without first talking to your doctor. You may need to use less and less before you stop the medication completely.

Avoid drinking alcohol. It may increase your blood levels of Migrales.

Migrales is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Active ingredient matches for Migrales:

Propranolol in India.

References

1. PubChem. "propranolol". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
2. DrugBank. "propranolol". http://www.drugbank.ca/drugs/DB00571 (accessed September 17, 2018).
3. MeSH. "Vasodilator Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology