<http://schema.org/articleBody>
" What is Migraleve\u00A0used for?  Short-term (up to three days) treatment of nausea and headache associated with a migraine attack when this is not relieved by paracetamol, ibuprofen or aspirin alone.  The\u00A0Migraleve pink tablets are\u00A0taken first, at the first sign of a migraine, to help prevent the migraine developing fully. They contain two painkillers,\u00A0paracetamol and\u00A0codeine (a combination\u00A0known as co-codamol), together with an anti-sickness medicine called\u00A0buclizine.\u00A0 \u00A0If the migraine continues after taking Migraleve pink, further treatment should be with the Migraleve yellow tablets to help relieve the headache. The\u00A0Migraleve yellow tablets contain just the painkillers, paracetamol and codeine.\u00A0 How does Migraleve\u00A0work?  The buclizine in Migraleve pink is used to treat the sensation of nausea that can occur in a migraine attack and thus prevent vomiting.\u00A0It works by stopping\u00A0the vomiting centre in the brain\u00A0from receiving nerve messages that would otherwise cause nausea and vomiting.  The paracetamol in both types of tablets\u00A0is\u00A0thought to relieve pain\u00A0by reducing the production of prostaglandins in the brain and spinal cord. Prostaglandins\u00A0sensitise nerve endings, causing pain. By\u00A0reducing\u00A0their production\u00A0paracetamol\u00A0is thought to\u00A0increase our pain threshold, so that although the cause of the pain remains, we can feel it less.  The codeine in both types of tablets is a slightly stronger painkiller known as an opioid.\u00A0Opioid painkillers work by mimicking the action of\u00A0natural\u00A0pain-reducing chemicals called endorphins that are produced\u00A0in the brain and spinal cord.\u00A0Codeine acts on the same\u00A0opioid receptors as natural endorphins and this\u00A0blocks the transmission of pain signals sent by the nerves to the brain. This means\u00A0that\u00A0even though the cause of the pain may remain, less pain is actually felt. Migraleve pink and yellow tablets contain 8mg of codeine,\u00A0which in combination with the paracetamol\u00A0is effective at relieving the pain of migraine headaches.  How do I take Migraleve?  Migraleve pink and yellow tablets can be taken either with or without food. Adults over 18 years of age should take two Migraleve pink tablets at the first sign of a migraine. If after four hours the headache is still there, you should then take two Migraleve yellow tablets every four hours as necessary. Maximum dose: eight tablets (two Migraleve pink and six Migraleve yellow) in 24 hours. Adolescents aged 15 to 18 years should take two Migraleve pink tablets at the first sign of a migraine. If after six hours the headache is still there, you should then take two Migraleve yellow tablets every six hours as necessary. Maximum dose: eight tablets (two Migraleve pink and six Migraleve yellow) in 24 hours. Children aged 12 to 14 years should take one Migraleve pink tablet as soon as it is known that a migraine attack has started or is imminent. If after six hours the migraine is still there, one Migraleve yellow tablet should then be taken every six hours as necessary. Maximum dose: four tablets (one Migraleve pink and three Migraleve yellow) in 24 hours. Do not take more than the recommended dose. Do not take Migraleve for longer than three days without consulting your doctor. Taking codeine regularly for more than three days can lead to addiction to the medicine and withdrawal symptoms when you stop taking it. Consult your doctor if your migraine doesn&amp;#039;t get better\u00A0despite taking Migraleve.  What should I know before taking Migraleve?  Migraleve may cause drowsiness, dizziness and blurred vision. If you are affected you should not drive or operate machinery and avoid drinking alcohol. In\u00A0March 2015 a new &amp;#039;drug driving&amp;#039; law came\u00A0into force that\u00A0allows\u00A0police to use roadside drug tests to check for the presence of\u00A0prohibited drugs in a driver&amp;#039;s saliva.\u00A0The medicines prohibited\u00A0by the law include morphine. Codeine is converted into morphine by the liver, which means\u00A0it may be an offence to drive while you are taking\u00A0Migraleve. You should not drive if you think this medicine affects your ability to drive safely, for example if it makes you feel sleepy, dizzy, unable to concentrate or make decisions, or if you have blurred or double vision.  People can vary considerably in the way that their body metabolises codeine. For some people this may lead to an increased chance of getting side effects, such as reduced levels of consciousness; sleepiness; slow, shallow breathing; &amp;#039;pin-point&amp;#039; pupils; lack of appetite; constipation; or nausea and vomiting. If you experience any of these you should stop using Migraleve and get medical advice straight away. For other people it may mean that the codeine is less effective, so if you find this medicine doesn&amp;#039;t relieve your symptoms well enough you should consult your doctor or pharmacist.  Do not take Migraleve with any other products that contain paracetamol. Many over-the-counter painkillers and cold and flu remedies contain paracetamol. It is important to check the ingredients of any medicines you buy without a prescription before taking them in combination with this medicine. Seek further advice from your pharmacist.   An overdose of paracetamol is dangerous and capable of causing serious damage to the liver and kidneys. You should never exceed the recommended dose of Migraleve. Get immediate medical advice in the event of an overdose with Migraleve, even if you feel well, because of the risk of delayed, serious liver damage.  Alcohol increases the risk of liver damage that can occur if an overdose of paracetamol is taken. The hazards of paracetamol overdose are greater in persistent heavy drinkers and in people with alcoholic liver disease.   Do not take Migraleve for longer than three days without consulting your doctor. If you take Migraleve regularly\u00A0for long periods of time, the body can become tolerant to it and it may become less effective at relieving pain. With prolonged use, the body may also become dependent on the codeine. As a result, when you then stop taking the medicine you may get withdrawal symptoms such as restlessness and irritability.  Taking a painkiller for headaches too often or for too long can actually make the headaches worse.  Who should not take Migraleve?  People who are known to have a genetic variation of a liver enzyme called CYP2D6, which metabolises codeine into morphine (CYP2D6 ultra-rapid metabolisers). These people are more likely to experience side effects after taking codeine, because they convert more codeine into morphine than other people. See\u00A0above. People with very slow, shallow breathing (respiratory depression), people having an\u00A0asthma attack\u00A0and people with\u00A0chronic obstructive pulmonary disease (COPD). People with liver failure. People with or\u00A0at risk of getting a blockage in the gut (paralytic ileus).  People with a head injury or raised pressure inside the skull (intracranial pressure). People who are intoxicated with alcohol.  Women who are breastfeeding. Children under 12 years of age. Children and adolescents under 18 years of age who have had surgery to remove their tonsils or adenoids (tonsillectomy or adenoidectomy or both) for obstructive sleep apnoea. Migraleve\u00A0is not recommended for adolescents aged 12 to 18 years whose breathing might be compromised, including those with neuromuscular disorders; severe heart or lung conditions; upper airway or lung infections; multiple trauma; or who have had extensive surgical procedures.   Migraleve should not be used if you are allergic to\u00A0any of its ingredients.\u00A0If you feel you have experienced an allergic reaction, stop using Migraleve\u00A0and inform your doctor or pharmacist immediately.  Who should get medical advice before taking Migraleve?  Elderly people. People with kidney or liver problems. People with lung problems such as\u00A0asthma\u00A0or\u00A0a condition called bronchiectasis, in which there is persistent widening of the airways as a result of lung disease, eg infection, inflammation, tumours or cystic fibrosis. People with biliary tract disorders, eg gallstones or recent surgery on the biliary tract. People with acute abdominal conditions such as appendicitis. People who have recently had surgery on the stomach, intestines or urinary tract. People who are constipated. People with inflammatory bowel disorders such as Crohn&amp;#039;s disease or ulcerative colitis. People who have difficulty passing urine, for example men with an enlarged prostate gland. People with an underactive thyroid gland (hypothyroidism). People with underactive adrenal glands, eg Addison&amp;#039;s disease. People with low blood pressure (hypotension) or shock. People with a condition involving abnormal muscle weakness called myasthenia gravis. People with a history of convulsions or fits, eg epilepsy. People with an irregular heartbeat (arrhythmia). People with a history or risk of narrow angle glaucoma. People with a history of drug abuse or dependence.  Can I take Migraleve while pregnant or\u00A0breastfeeding?  Get\u00A0medical advice from your doctor or midwife\u00A0before using Migraleve if you are pregnant.\u00A0Migraleve\u00A0should be avoided during pregnancy and the late stages of labour, unless considered essential by your doctor, and then\u00A0used\u00A0only if the expected benefit to the mother outweighs any potential risk to the baby.\u00A0Paracetamol is not known to be harmful when used during pregnancy. However, the safety of buclizine and codeine\u00A0during pregnancy has not been\u00A0established. If codeine is used regularly in the third trimester it may cause withdrawal symptoms in the baby after birth. If used during labour it may cause breathing difficulties in the baby after birth.\u00A0 If you are breastfeeding you should not take Migraleve.\u00A0It is not known if buclizine passes into breast milk. Paracetamol and codeine may pass into breast milk in amounts that are probably too small to be harmful in most people. However, because some people metabolise codeine in a slightly different way that can increase the risk of getting side effects from the medicine, it is recommended that women who are breastfeeding do not take codeine. It is impossible to predict which women and babies will metabolise codeine differently. Potential side effects in a nursing baby may include drowsiness or sedation, difficulty breastfeeding, vomiting, breathing difficulties and floppiness.\u00A0  What are the possible side effects of Migraleve? Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with paracetamol, codeine and buclizine. Just because a side effect is stated here does not mean that all people using Migraleve\u00A0will experience that or any side effect.  Drowsiness. See warnings above. Dizziness. Constipation. Nausea and vomiting. Dry mouth. Sweating. Itching. Skin rash. Difficulty passing urine. Headache. Confusion. Blurred vision. Dependence on the medicine if used regularly or for long periods of time (see above).  Talk to your doctor, nurse or pharmacist if you want any more information about the possible side effects of Migraleve. If you think you have experienced a side effect, did you know you can report this using the\u00A0yellow card website? Can I take Migraleve with other medicines? If you are taking any other medicines, including those bought without a prescription and herbal medicines, it is important to check with your pharmacist or doctor\u00A0before you take Migraleve as well, to make sure that the\u00A0combination is safe. Migraleve should not be taken by people who have taken\u00A0a monoamine oxidase inhibitor (MAOI) medicine\u00A0in the last 14 days.\u00A0MAOIs include the antidepressants\u00A0phenelzine,\u00A0tranylcypromine,\u00A0isocarboxazid\u00A0and\u00A0moclobemide\u00A0and the anti-Parkinson&amp;#039;s medicine\u00A0selegiline.   Don&amp;#039;t take\u00A0other medicines that contain paracetamol\u00A0in combination with Migraleve, as this can easily result in exceeding the maximum recommended daily dose of paracetamol. Many\u00A0cold and flu remedies\u00A0and\u00A0other painkillers\u00A0contain paracetamol so be sure to check the ingredients of any other medicines before taking\u00A0with this one, or ask your pharmacist for advice. (Paracetamol is known as acetaminophen in the USA and some other countries). It is fine to take Migraleve with ibuprofen. Migraleve\u00A0may cause drowsiness. This is more likely if you take it\u00A0with any of the following, which can also cause drowsiness:  antipsychotics, eg haloperidol, chlorpromazine  benzodiazepines, eg temazepam, diazepam  sleeping tablets, eg zopiclone  other sedating antihistamines, eg chlorphenamine, promethazine, triprolidine, hydroxyzine (some of these may be found in non-prescription cough and cold or hayfever remedies)  other strong opioid painkillers, eg dihydrocodeine, morphine, tramadol   tricyclic antidepressants, eg amitriptyline.   Codeine \u00A0can reduce the muscular activity in the gut and so may oppose the effect of the following medicines on the gut:  domperidone  metoclopramide.  There may be an increased risk of side effects such as constipation, dry mouth and blurred vision if Migraleve\u00A0is taken with antimuscarinic medicines that can cause these type of side effects, such as the following:   antimuscarinic medicines for Parkinson&amp;#039;s symptoms, eg procyclidine, orphenadrine, trihexiphenidyl   antimuscarinic medicines for urinary incontinence, eg oxybutynin, flavoxate, tolterodine, propiverine, trospium  antispasmodics, eg atropine, hyoscine.  There is a risk of severe constipation if codeine is used with antimotility medicines for diarrhoea, such as loperamide. Quinidine, rifampicin\u00A0and\u00A0ritonavir\u00A0may reduce the painkilling\u00A0effects of codeine. Colestyramine\u00A0reduces the absorption of paracetamol from the gut. It should not be taken within an hour of taking Migraleve or the effect of the paracetamol will be reduced. Other medicines containing the same active ingredients Migraleve pink and Migraleve yellow are both available separately. Last updated 18.02.2015 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/aches-and-pains/a7935/migraleve-paracetamol-codeine-and-buclizine/>