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Read the latest update on Midrin here: Midrin-October 2011 Update
For many years, Migraineurs have turned to Midrin as their Migraine abortive medication. Midrin is a compound of three ingredients: isometheptene mucate, dichloralphenazone, and acetaminophen. The isometheptene mucate helps reverse the vasodilation that sometimes occurs during a Migraine. Dichloralphenazone is a sedative. Acetaminophen is a simple analgesic.
Over the years, other medications with the exact same ingredients have been sold under other names including Amidrine, Duradin, Epidrin, Isocom, Midchlor, Midchlor, Migratine, and others. The medication has also been available with no brand name, simply labeled isometheptene mucate / dichloralphenazone / acetaminophen. It’s a bit confusing, but none of these were actually “generic” versions of Midrin.
For a few years now, Midrin has been unavailable at times because of manufacturing problems. Recently, Midrin and all of the other equivalent products have disappeared from pharmacies. Midrin and some of the “brands” have been discontinued permanently. Others show as being back ordered when pharmacies attempt to order them.
Here’s a response I received on December 13, 2010, after I contacted the FDA about this issue:
Thank you for writing to the Division of Drug Information in the FDA’s Center for Drug Evaluation and Research.
I believe most, if not all, manufacturers have ceased to make Midrin and its ‘generic’ versions. FDA has not yet asked manufacturers to discontinue manufacturing. However, please understand that Midrin has never been approved by FDA, and companies may have ceased manufacturing to comply with FDA regulations
Midrin is not FDA approved, but is on the Drug Efficacy Study Implementation (DESI) list. Since there is no approved application for Midrin, there are no approved generics for this product either. The products you are referring to are not generics, but rather other products that contain the same ingredients as Midrin.
The following is a brief general history, relevant to Midrin:
In 1962, Congress amended the 1938 Food, Drug and Cosmetic Act to give the FDA the authority to regulate medicines on the basis of efficacy in addition to safety. That is, the amendment required manufacturers to show that their drug products were effective, as well as meeting the requirement of the earlier Act, that the products must be safe. As a result of the 1962 amendment, all the drugs approved under New Drug Applications (NDAs) between 1938 and 1962 had to be reviewed again for efficacy. Furthermore, for every drug initially sold between 1938 and 1962 with approval by FDA, five others were sold without FDA approval. Many of these drugs were chemically identical copies of previously approved drugs, and hence were known as “me-too” drugs. Many others were combinations of approved ingredients. FDA decided that the efficacy study, to be fair and to accomplish its purpose of improving therapeutics in the United States, had to apply as well to these non approved drugs. Because the resources of the FDA were too limited to do this, the agency asked the National Academy of Sciences/National Research Council (NAS/NRC) to assist in the review effort. The NAS/NRC chose 30 panels, each composed of six experts, to conduct the review of various categories of drugs. The manufacturers of drugs with NDAs that had been submitted between 1938 and 1962 were asked to submit to the FDA their evidence that the drug was effective. The NAS/NRC panels then reviewed the data. In late 1967, the panels began submitting their reports to the FDA. The FDA formed a task force to implement the recommendations in the reports. This was the Drug Efficacy Study Implementation (DESI) task force. DESI products can continue to be marketed until a final determination is made.
When I replied, expressing my concern for the many Migraineurs for whom Midrin and its equivalents are the only abortive medications they can use, I received this reply:
We understand your concerns. However, in order to keep Midrin on the market, a company will need to submit a new drug application to FDA, and FDA will subsequently have to approve the application. FDA has serious concerns that drugs marketed without required FDA approval may not meet modern standards for safety, effectiveness, quality, and labeling. The FDA drug approval process provides a review of product-specific information that is critical to ensuring the safety and efficacy of a finished drug product. For instance, the applicant must demonstrate that its manufacturing processes can reliably produce drug products of expected identity, strength, quality, and purity. Furthermore, FDA’s review of the applicant’s labeling ensures that health care professionals and patients have the information necessary to understand a drug product’s risks and its safe and effective use.
After this exchange with the FDA, I set out to discover if any of the pharmaceutical companies were planning to apply for FDA approval and continue manufacturing their medication. I have found only one company working on it – Excellium Pharmaceuticals, the maker of Epidrin.
On Friday, January 28, I spoke with an official at Excellium regarding the status of Epidrin. They have been working with the FDA and have asked the FDA to enter into an agreement with them to allow them to resume shipping Epidrin based on the safety and efficacy data they have collected to date and the track record of these medications over the years. If they can reach such an agreement with the FDA, shipping of Epidrin could resume shortly. If, however, such an agreement cannot be reached, they would have to conduct clinical trials and file a new drug application (NDA) for FDA approval of Epidrin. This would take a minimum of two years, during which they could not manufacture or ship Epidrin.
Excellium expects to know the outcome of their discussions with the FDA by the end of this week.
You can read the latest update on Midrin here: Midrin-October 2011 Update
Live well,
© Teri Robert, 2011
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Tammy Norton (Tue, 22 Mar 2011 01:51:22 +0000): Epidrin makes me unstable , angry and mean spirited.... does anyone else have this efect?
I was shot in the head and am missing part of my brain.
Star Fowler (Tue, 10 May 2011 22:54:02 +0000): sounds like you need something stronger,such as Morphine.
Mandy Martin (Wed, 12 Oct 2011 22:12:42 +0000): Great news! My pharmacist informed me today they are making Midrin again and it is available. My prescription will be ready tomorrow! Spread the word!
Angie Bowman (Fri, 18 Nov 2011 03:45:51 +0000): have you tried anything else,,so sorry to hear about youre trouble,,,,i get shots that are morphine,only thing that helps,puts me to sleep,,but only lasts a few days then here i go again
Carla Toby (Thu, 07 Apr 2011 10:55:55 +0000): I have found this experience very frustrating. I am now taking Migranol, or DHE 45, which is an ergot-based medication. It works, but only *after* the pain starts. Midrin was effective *before* the pain, as it was prescribed for use during the aura. Now, I have to suffer longer and the Migranol may or may not work on my migraines. People who don't have migraine headaches cannot possibly understand the debilitating effects of this pain. The FDA is just one more government agency which thinks it knows best what I should put into MY body, and I resent this intrusion.Mandy Martin (Wed, 12 Oct 2011 22:12:37 +0000): Great news! My pharmacist informed me today they are making Midrin again and it is available. My prescription will be ready tomorrow! Spread the word!
Angie Bowman (Fri, 18 Nov 2011 03:38:34 +0000): i know exactly how you feel,the gov is dictating the fda,,,,all docs i have seen so far are afraid to give medication,,been suffering for a very long time,,,and who do they think they are telling us how much pain we are in,and what our body can take,,,,i used to take some good medicine in germany for my migraines,,,,i cant believe that the government is able to control my body my pain,how dare they,,the fda should stand fast,,,i would like it very much if one of them would hae to put up with a migraine for a couple of days,,,dont you think they would approve the medication in hours of time,i do,,,,,wish i could send or call the mh whitehouse,,,tell them what i think,,,they are not in the pain we endure,,,i was tod to go to the hospital and get my usual shots,,,what a mess
Celeste B Waters (Sat, 16 Apr 2011 19:21:53 +0000): Hello Teri
I had not had migraines for may years. However now they have come back with a vengeance. You can imagine my disbelief when I discovered that midrin or any of its equivalents were no longer available! It was the ONLY med that worked.
Please, do you have any up dates on whether Excellium is going to go ahead with doing trials to get FDA approved or do you know if the ingredients separately are still available?
Thank you,
Celeste
Teri Robert (Fri, 22 Apr 2011 03:45:19 +0000): Celeste, Excellium is not going to do trials and apply for approval. Some compounding pharmacies are making Midrin equivalents for people; some are having problems getting ingredients. Latest update at http://migraine.com/blog/update-migraine-abortive-midrin-33111/
Celeste B Waters (Sat, 14 May 2011 03:51:17 +0000): If have possibly found a compound pharmacy that may be making a substitute. The ingredient that is no longer available is the sedative I side it. The pharmacist I spoke to said she may substitute it with chloral hydrate which is a very old sedative. It might work?? The other 2 ingredients they can buy in bulk. If you would likeCeleste B Waters (Sat, 14 May 2011 03:52:01 +0000): for me to keep you updated I would be happy toCeleste B Waters (Fri, 17 Jun 2011 02:24:18 +0000): There is a compound pharmacy that is making a subsistute for midrin there using chlorohydrate instead of the sedative in midrin. The combination is not nearly as good but I find with ibuprofen taken with each dose of the new compound it does help.Mandy Martin (Wed, 12 Oct 2011 22:12:26 +0000): Great news! My pharmacist informed me today they are making Midrin again and it is available. My prescription will be ready tomorrow! Spread the word!
Lara James (Tue, 10 May 2011 04:58:44 +0000): Midrin was the only thing that controlled my migraines and gave me a normal existence for years. I'm terrified of facing my next migraine without it. Guess the FDA knows what's best for me. Yeah, my @$$ they do!
Kyllie Pobar (Tue, 10 May 2011 07:18:19 +0000): This was my only cure too until it started making me all loopy
Erica Gloden (Tue, 10 May 2011 12:12:07 +0000): Weird, I just got it a few weeks ago?Lara James (Thu, 12 May 2011 19:31:03 +0000): Stock up now!!!!Lara James (Thu, 12 May 2011 19:31:40 +0000): Kyllie - two pills make me loopy. I usually take just one and it does the trick when I catch the migraine coming.
Paul J Strawbridge (Tue, 19 Jul 2011 18:28:28 +0000): Same with me! I'm terrified that I can't get Midrin for my migraines. I've been using it for 15 years!!!! What do we do??? Mandy Martin (Wed, 12 Oct 2011 22:12:32 +0000): Great news! My pharmacist informed me today they are making Midrin again and it is available. My prescription will be ready tomorrow! Spread the word!
Angie Bowman (Fri, 18 Nov 2011 03:29:49 +0000): Erica Gloden,,,
hello i would like to know where you are living you can get the meds,im in virgina and the docs here are listening more to the gov.then us patients
would greatly appretiate all information 
Bobbie Haggard (Sun, 24 Jul 2011 14:11:18 +0000): I suffer migraines, and used midrin with great success for years. I have tried topamax ad a preventive, made me sick, high blood pressure, worse migraines than before. Tried imtrex, made my blood pressure go way up, dizzy, in a fog. I hope one day soon they will bring back midrin.Teri Robert (Sun, 24 Jul 2011 14:54:15 +0000): Bobbie, I think there's very little chance that Midrin will be brought back. BUT, you can ask your doctor to write a prescription, listing out the individual ingredients in it, and take it to a compounding pharmacy. They can make a Midrin equivalent for you.Mandy Martin (Wed, 12 Oct 2011 22:12:17 +0000): Great news! My pharmacist informed me today they are making Midrin again and it is available. My prescription will be ready tomorrow! Spread the word!
Angie Bowman (Fri, 18 Nov 2011 03:26:06 +0000): Mandy
hello my name is angie
wouldaid of the government mind telling me where you live
i live in virginia and its like real hell trying to get a doctor even a neurologist to give one anything at all,
most of them are afraid to give anything that works becouse of the government,
any news would be more then appreciatet
thanks
Angie Bowman
Tim Tieu (Fri, 29 Jul 2011 23:26:43 +0000): Not true. You can still get Midrin using a Compounding Pharmacy. WWW.NBFCP.COM
Robin A Viars (Sat, 30 Jul 2011 04:10:15 +0000): my husband has been taking midrin for years and nothing works like it. now we cant get it or the epidrin, it really works.Teri Robert (Sat, 30 Jul 2011 17:25:53 +0000): Robin, ask your doctor to give you a prescription that you can take to a compounding pharmacy where they can make a Midrin equivalent medication for you.
Kimberly Costello (Sat, 20 Aug 2011 23:21:20 +0000): I've tried this and the problem is one of the main ingredients in Midrin/Epidrine is unavailable. My compounding pharmacist has been trying for six months to get it. This has been a depressing development for me; I've been a cluster headache sufferer for 30 years, and a guinnea pig for every neurologist who insisted I had migraine. Misdiagnosed for 15 years, I finally found something that worked -- and now it's gone,Tim Tieu (Tue, 20 Sep 2011 23:00:05 +0000): Have your doctor contact Northbay Family Compounding Pharmacy 707-421-1117. They can make it for you. ThanksMandy Martin (Wed, 12 Oct 2011 22:12:09 +0000): Great news! My pharmacist informed me today they are making Midrin again and it is available. My prescription will be ready tomorrow! Spread the word!
Angie Bowman (Fri, 18 Nov 2011 03:21:20 +0000): Kimberly Costello
i know exactly how you feel seems like the docs have to listen to the govenment instead of the patient anymore,,,thats why im on here looking for something that will help me,,ive had these since i was 16 years old am 59 now,,neuroligist wants to give me BOTOX,,apperently its approved for migraines but the side affects are very bad headaches and to be hospitalized,,,no thank you! so thanks for sending and sharing,im tired of hurting all the time,it has dissabled me where im not able to work anymore,im tired of the drugs that dont work,i was told to go to the ER and get my shots,,,now hows that for a specialist?????
Kristi Adams (Tue, 09 Aug 2011 02:51:48 +0000): I have taken many meds for migranes over 20 years have had bad reactions to all of the tripans, I am very sensitive to other meds midrin was and is my only hope to help control them and live a normal life and function with my family.Mandy Martin (Wed, 12 Oct 2011 22:11:57 +0000): Great news! My pharmacist informed me today they are making Midrin again and it is available. My prescription will be ready tomorrow! Spread the word!
Marie Beason Hickman (Tue, 30 Aug 2011 20:37:06 +0000): I just went to renew my pres and after 3 pharmacies only found 25 pills, where would you find a compounding pharmacy?Mandy Martin (Wed, 12 Oct 2011 22:12:01 +0000): Great news! My pharmacist informed me today they are making Midrin again and it is available. My prescription will be ready tomorrow! Spread the word!
Teri Robert (Thu, 13 Oct 2011 02:57:53 +0000): Mandy Martin when you pick up your prescription, would you please come back and give us the information from the bottle about who's making it. I checked with the FDA, and they said nothing has been approved, so I'm curious.Mandy Martin (Thu, 13 Oct 2011 03:05:58 +0000): Teri Robert Yes, I will be glad to. I am picking it up tomorrow.Mandy Martin (Thu, 13 Oct 2011 22:04:23 +0000): Teri Robert ok - The pills are made by Macoven Pharmaceuticals out of Magnolia, TX. The pills are labeled: Isometh/Dich/Apap Caps. They are not being called Midrin - I believe the name is trademarked. But they are identical to Midrin.
I am glad there are available. My insurance wouldn't pay for the compounded medicine, but it did pay for this.Teri Robert (Fri, 14 Oct 2011 03:25:43 +0000): Mandy Martin, thanks!Mandy Martin (Fri, 14 Oct 2011 03:27:31 +0000): Teri Robert - You are quite welcome. I want everyone to know it is available again. The past year has been hell for all of us.
Angie Lebel (Sun, 18 Sep 2011 02:45:17 +0000): I found on another site in response to midrin being discontinued that a compunding company in delaware was still making midrin at only $1 a pill - its called safeway compounding company (you can google it) and they are OUTSTANDING! you just need a prescription from your doctor for as many pills as you would like and within a week they send it out to you by ups with a shipping cost of $10 -these prices are amazing compared to what I was paying at the pharmacy hen I could get them locally - I HIGHLY recommend this company and suggest that you spread the word to any and all migraine sufferers everywhere! their customer service is superb as well - good luck!Mandy Martin (Wed, 12 Oct 2011 22:11:22 +0000): Great news! My pharmacist informed me today they are making Midrin again and it is available. My prescription will be ready tomorrow! Spread the word!
Cheryl Low (Thu, 13 Oct 2011 00:38:04 +0000): Sorry, I never met a migraine that a qualude couldn't handle... So start wishing for them to be manufactured again too, please! LOL:)
Cristen Likens (Thu, 13 Oct 2011 01:38:29 +0000): mandy, you just heard, like today?, that midrin will be made again? my pharmacist and dr just told me today that they aren't.... I'm confused...Mandy Martin (Thu, 13 Oct 2011 03:05:16 +0000): Yes, the Medicine Shoppe in Warner Robins, GA is getting shipment tomorrow. She was going to compound it for me and when I went in she said when she went to order the ingredients, it showed Midrin was available again and she ordered it.
You can call her at (478) 922-2067. Her name is Janet Speckter.Mandy Martin (Thu, 13 Oct 2011 22:06:29 +0000): The pills are made by Macoven Pharmaceuticals out of Magnolia, TX. The pills are labeled: Isometh/Dich/Apap Caps. They are not being called Midrin - I believe the name is trademarked. But they are identical to Midrin.
The pharmacist, Janet Speckter, at The Medicine Shoppe in Warner Robins, GA (478) 922-2067. is the one who got them for me. She said anyone can call and she will fill prescriptions for them.
I am glad there are available. My insurance wouldn't pay for the compounded medicine, but it did pay for this.
Kathleen Wilczynski (Thu, 13 Oct 2011 23:40:23 +0000): This is a godsend! I have tried Imitrex with bad side effects, Maxalt that will take away aura and numbness but doesn't touch the pain and completely knocks me out! I am sooo happy I looked here!
Susanne Angelina (Mon, 17 Oct 2011 17:18:21 +0000): How old are these posts? My pharmacist in NY said that nothing is available at this time. Also, my insurance will only cover a generic brand. Can anyone help me out. Today is 10/17/2002 Thank you for any help that can be given.
Vikki Cantin (Thu, 20 Oct 2011 15:13:37 +0000): mandy..do you think they would fill one from mn?Teri Robert (Wed, 26 Oct 2011 18:54:03 +0000): Vikki, this may well be available where you are. Working on a new blog entry about this now. It will be up soon. Mandy Martin (Fri, 18 Nov 2011 03:28:48 +0000): Yes, the pharmacist said they could do that, Vikki. It is the Medicine Shoppe in Warner Robins, GA. 478-922-2067. Ask for Janet Speckter.Teri Robert (Tue, 22 Nov 2011 04:07:42 +0000): Vicki, in case you didn't see it, take a look at http://migraine.com/blog/news/midrin-migraine-october-2011-update/ 
Anita Bunting (Fri, 21 Oct 2011 01:00:51 +0000): I even checked Canadian pharmacies - and no Midrin. This is the only migraine medications that works for me and does not make me sick. I feel left out in the cold!Teri Robert (Fri, 21 Oct 2011 03:00:34 +0000): Anita,
I still can't find it anywhere. Mandy said she'd been told about and got some new generic being made, but the FDA site shows no approvals. Your doctor can write you a prescription for the ingredients in Midrin, and you can take it to a compounding pharmacy where they can make a Midrin equivalent for you. BTW, I asked the FDA about ordering it from another country. They said that, if it could even be found, importing it would be illegal since it's not an approved drug in the US. That means that if customs happened to spot the package entering the country, they'd confiscate it, and you'd just be out the money spent.Angie Bowman (Fri, 18 Nov 2011 04:01:52 +0000): this is 2011,11, and they still cant help me, even a neurologist,, what does that say for the fda?
i wish someone would let me know how I could optain medication that actually works, and that my doc will give me,,, this is absolutely awfull in the usa,,, who are they to tell me how much pain I'm in or what medication I should or not have,,, im tired of suffering all the time been suffering for over 40 years and they worry about getting hooked,,, like I care at my age.Teri Robert (Fri, 18 Nov 2011 04:26:58 +0000): Angie, neurologists aren't necessarily Migraine and headache specialists. I hate to see you suffering. Have had Migraines myself for over 50 years now. Take a look at http://migraine.com/blog/how-are-migraine-specialists-different/ 
Deborah Skanadore Reisdorph (Mon, 21 Nov 2011 22:51:56 +0000): Please tell me if you know where to get some midrin!Teri Robert (Tue, 22 Nov 2011 04:03:47 +0000): Yes, Deborah! You can find information about a company that's still manufacturing a Midrin equivalent and how your pharmacist can order it here - http://migraine.com/blog/news/midrin-migraine-october-2011-update/ 
Janet Carter (Tue, 29 Nov 2011 00:51:47 +0000): You can find a compounding pharmacist at www.iacprx.org. Or you can contact me, as I own a compounding pharmacy. Midrin is only available through a compounding pharmacy. Janet Carter, RPh, at rxalt@aol.com.
Erika Cormier (Sun, 04 Dec 2011 04:45:24 +0000): FYI: There is a wonderful company that makes compound medicines, and they currently make a Midrin equivalent. The site is: http://www.ourkidsasd.com/ There are several companies that are part of this 1 company, and they can make an equivalent to anything and everything, topically & orally. They just last month announced their product for Midrin....
Marvel Denomme (Tue, 27 Dec 2011 16:38:18 +0000): Midrin is the only thing that works for me over the pass 40 yrs of suffering I finally found Midrin to help now they stopped making it. HELP!
"The first migraine I remember was when I was about 4. I remember rocking back and forth curled up on my knees sort of gently bumping my head in rhythm to the pain. No one ever helped because it was widely assumed I was 'just looking for attention.'” 
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Kathleen,
I’ve been checking into this. Keep your eyes open for a new blog entry I’m working on to answer these questions.
Teri
A generic Midrin manufactured by Macoven Pharmaceuticals seems to be sporadically available. Are they leftovers or new production? I’m keeping my fingers crossed! Good luck everyone!