Q: I am a 30-year-old female suffering from menstrual migraines (that is what I think these are) most of the time, though I get mild attacks about 2-3 times otherwise also in a month, but most severe ones are around my periods. I take Vasograin when I get an attack and it usually relieves the pain. Is it safe to take Vasograin 4-5 times in a month or is there any other alternative? I am also taking Beplex Forte and Shellcal 250 since about a year.

A:Vasograin is the brand name of a multi-ingredient product that contains several agents, i.e. ergotamine, paracetamol, caffeine, and prochlorperazine. Many women get migraine attacks during their menstrual period. Ergotamine is effective in some patients, but it has many side effects, and some of them are quite serious such as reduced blood supply to heart (coronary arteries ischaemia) and intestines, pleural fibrosis, tingling and numbness of the extremities, etc. Hence, its use has been limited particularly, since now safer medicines are available. Prochlorperazine is only required if there is nausea and/or vomiting. The treatment of migraine is as follows: avoid trigger factors, rest in a quiet dark place, initially take a simple analgesic such as aspirin or paracetamol (Crocin 650 mg). If these measures are not effective,then rizatriptan (sold as Rizact) 5 mg should be taken whole with water, and the dose can be repeated after two hours, if necessary. These measures are to be taken to tackle acute attacks. Patients with recurrent attacks should also take regular, preventive treatments such as flunarizine (sold as Nomigrain) or propranolol (sold as Inderal), etc. I do not know why you are taking Beplex Forte and Shellcal. Such supplements have no role and people with normal diet do not need such supplements. Some of them such as Shellcal can produce crystals in the urine and kidney stones. I presume you are not taking any hormonal contraceptive pill since it tends to increase attacks and make them more severe.