Using a Compounding Pharmacy to Replace Midrin or Epidrin

Midrin (and all other Midrin-like drugs, including Epidrin) have really, truly been discontinued. I’ve tried to hide from the truth, but can no longer deny that the ONE medication that allows me some semblance of a life has been discontinued for bureaucratic reasons. While there are no similar medications on the market to replace Midrin, having a pharmacist compound the medication is an option.

What are compounded medications? Quite simply, they are medications that pharmacists mix up from their component materials. You can locate a compounding pharmacy in most US states. All you need is a prescription from your doctor. Insurance companies generally pay for compounded prescriptions, though there may be additional costs that you pay for up front, then contact your insurance company for reimbursement. (I found this answer online and have no first-hand experience. If you know more, please leave a comment.)

But there’s a catch… the individual ingredients may be difficult to obtain. Midrin is composed of isometheptene mucate, dichloralphenazine, and acetaminophen. One pharmacist reported that she is unable to obtain dichloralphenazine and my headache specialist said that isometheptene mucate is backordered many places. However, these are only a few reports. It’s up to you to share what you learn!

If you’re a Midrin devotee, keep calling pharmacies — some still have a stash. I found mine at an independent pharmacy. Have your doctor call in a prescription for as many as possible. Insurance will probably only cover one month; if you pay cash, you can probably get a three-month supply. They cost about $1 per pill. Also try your mail-order pharmacy for a three-month supply that insurance should cover. (FYI, Costco and BioScrip are out.)

Read Teri Robert’s post for the politics of Midrin’s discontinuation. She has also found that Prodrin is available, though it doesn’t contain dichloralphenazine.

UPDATE: The Midrin equivalent is being manufactured again! Contact your local pharmacy for availability and pricing. Near me, it’s available at CVS, Walgreens, Walmart and a local independent pharmacy. My insurance covers it with a generic copay.


Name Brand and Generic Midrin Discontinued

When I tried to fill my Midrin prescription today, the pharmacist told me that all formulations of the drug have been discontinued. Migraineurs throughout the US have heard the same news over the last three years, though the trouble has become more acute in recent months. Migraine advocate Teri Robert researched the issue and confirms the reports. Midrin, Amidrine, Duradrin, Epidrin, Isocom, Migquin, Migrapap, Migratine, Migrazone (all brand names of meds with the same ingredients as Midrin) and the generic isometheptene mucate/ dichloralphenazone/ acetaminophen have been discontinued.

Midrin appears to be a casualty in FDA’s attempt to subject all medications to current approval requirements. Teri explains,

“Midrin was first made and marketed before the current FDA drug approval process was in place. It was never reviewed by the FDA for efficacy and safety. Nor were any of the other similar products. And that’s where the problem lies.” …

“The loss of Midrin as a treatment option isn’t good news for us. The likelihood of any company investing the time and research dollars necessary to apply to the FDA for a drug equivalent to Midrin is slim. Yes, many people are still using it, but far fewer than before the triptans were developed, and triptan usages is up. The cost of triptans is down since two of them are now available as generics.”

Read all of Teri’s article, including her correspondence with an FDA official, on Help for Headaches & Migraine. Many thanks to Teri for her excellent sleuthing and dedication to helping migraineurs.

I’m crushed to learn that one of the few drugs to provide me with any relief is no longer available.

Update: The Midrin equivalent is once again available as of late 2011. Not all doctors and pharmacists are aware of this. If you are told Midrin isn’t available, tell them that Macoven Pharmaceuticals makes a generic equivalent and ask them to look into it.