Buccastem

What is Buccastem?

Buccastem are tablets which treat nausea and vomiting caused by migraines.   

How does Buccastem work?

Buccastem contains the anti-sickness medicine prochlorperazine. It works by blocking the dopamine receptors in the vomiting centre of the brain. This stops the nerves from communicating feelings of nausea, preventing the vomiting reflex from being triggered.  

What is a migraine?

A migraine is an intense headache with sensory disturbance. It also produces additional symptoms like nausea, being unable to tolerate bright lights or loud noises and having disturbed vision. 

What are the symptoms of a migraine?

The symptoms of a migraine include: 

• An intense pain usually on one side of the head 

• A throbbing or pulsing pain 

• Heightened sensitivity to light and sound 

• Visual disturbances 

• Dizziness 

• Lightheadedness 

• Poor concentration 

• Upset stomach 

• Pins and needles 

• Difficulty speaking 

Not everyone will experience all of these symptoms and some people may experience a migraine without a headache. If you experience visual disturbances such as flashing lights or a zig zag pattern this is known as a migraine with aura.

What is the difference between a headache and a migraine?

A migraine is more intense than a headache and results in additional symptoms alongside the pain of a headache. It's common to experience nausea and a sensitivity to light and noise during a migraine attack. You may also experience visual disturbances such as seeing flashing lights or patterns of light. This is known as a migraine with aura. 

What causes migraines?

The exact cause of migraines is unknown but it is thought to be linked to changes in the brain activity. It is also likely that your genes may make you more susceptible to suffering from migraines. There are a number of triggers which are known to cause migraines. These include: 

• Hormonal changes 

• Emotional triggers such as excitement, shock and tension 

• Depression and anxiety 

• Stress

• Feeling tired 

• Lack of sleep

• Working irregular shifts 

• Bad posture

• Jet lag 

• Hypoglycaemia 

• Missed meals 

• Dehydration 

• Alcohol 

• Caffeine 

• Cured meats and fish

• Chocolate and citrus fruit 

• Exposure to screens or flickering lights 

• Bright light 

• Strong smells

• Exposure to tobacco smoke 

• Loud noises 

• Climate changes 

• A stuffy environment 

• Certain medications

Keeping a migraine diary can help you to determine what your triggers are so that you can avoid them.

Are migraine auras dangerous?

Migraine auras are not usually dangerous. While it can be unsettling to experience the visual disturbances like flashing lights, blind spots, zig zag patterns or stars, these symptoms do not last long and will only have a temporary effect on your vision. You should see your doctor if you experience this so that they can prescribe you with an appropriate treatment. 

Can a migraine lead to a stroke?

A study published in British Medical Journal 2016 states that individuals who suffer from migraine with aura are at double the risk of a stroke. Discuss your symptoms with your doctor so that they can help you keep your symptoms under control. 

Can stress cause migraines?

Stress is a common trigger for migraines. Finding ways to manage stress and making time for self care may help to reduce the number of migraine attacks you experience if stress is a problem for you. 

What are the different types of migraine?

The different types of migraines include: 

• Migraine without aura (no visual disturbance)

• Migraine with aura (with visual disturbance)

• Chronic migraine (more than 15 days per month)

• Menstrual migraine (triggered by your period)

• Hemiplegic migraine (a rare condition causing weakness on one side)

• Abdominal migraine (seen in children) 

Active ingredients

The active ingredient in Buccastem is prochlorperazine maleate. 

Inactive ingredients

The other ingredients are compressible sugar (sucrose), povidone K30, xanthan gum, locust bean gum, talc, magnesium stearate and riboflavin sodium phosphate.

How to take Buccastem

Buccastem should not be swallowed whole or chewed. To use Buccastem, place the tablet underneath your upper lip alongside your gum. The tablet is designed to soften and stick to the gum. It dissolves gradually and the medicine will be released into the bloodstream. You'll likely stop noticing it after it's been there for a couple of minutes. Ensure you do not move the tablet around with your mouth and do not eat while the tablet is in. 

The recommended dose is 1-2 tablets twice a day for a maximum of two days. Always take Buccastem as your doctor or pharmacist has prescribed. 

What should I do if I forget to take Buccastem?

If you forget to take Buccastem just use it when you remember as long as you do not take double the dose to make up for a missed one.

What should I do if I take too much Buccastem?

If you take too much Buccastem then seek medical attention right away. Take the packet with you so that the hospital can see what you've taken.

Possible side effects include: 

• Drowsiness 

• Dizziness 

• Dry mouth 

• Insomnia 

• Agitation 

• Skin reactions 

• Photosensitivity 

• Low blood pressure 

• High blood sugar 

• Cholestasis 

• Abnormal movements or Tremors 

• Impotence

• Ejaculation problems 

• Painful erections 

• Gum irritation 

Rare side effects may include: 

• Jaundice 

• Blood problems 

• Swollen breasts in men or women 

• Breast secretion 

• Lack of menstruation 

• Restlessness 

• Anxiety 

Serious side effects can arise and need immediate medical attention. These may include: 

• Allergic reaction (swelling around the face, rash and difficulty breathing)

• High temperature, muscle stiffness, pale complexion and lack of alertness 

• Convulsions 

• Infection which may cause headaches, sweating, shivering, high temperature, sore throat, flushing or swollen glands 

• Blood clots

• Decreased sodium concentration in the blood

Contraindications

Buccastem should only be used if your doctor has confirmed that you suffer from migraines. Do not use Buccastem if: 

• You are allergic to any of the ingredients contained in the medicine 

• You are pregnant or breastfeeding 

• You have liver problems 

• You have blood problems 

• You have epilepsy 

• You have Parkinson's Disease 

• You have Glaucoma 

• You have problems with your prostate gland 

• You are under 18 

Talk to your doctor before taking Buccastem if any of the following apply to you: 

• If you are elderly 

• If you have risk factors for blood clots or strokes 

• If you have a family history of blood clots 

• If you have myasthenia gravis 

• If you have AIDS

It's recommended to use sun protection and avoid direct exposure to the sun while you are using this medication. Buccastem can increase your sensitivity to sunlight. 

Drug Interactions

Certain medications may interact with Buccastem. If you are taking any of the following medicines, ensure you tell your doctor: 

• Sedatives or tranquillisers 

• High blood pressure medications 

• Anticholinergic medications 

• Anticonvulsants 

• Lithium 

• Desferrioxamine 

• Anticoagulants 

• Levodopa 

Buccastem and pregnancy

Buccastem is not safe to use during pregnancy. Speak to your doctor who can recommend a suitable treatment. 

Buccastem and alcohol

It is not recommended to drink alcohol while taking Buccastem as this can cause an interaction. 

Buccastem and driving

Buccastem can cause drowsiness so you should not drive or operate machinery until you know how the medicine affects you.

Alternatives to Buccastem

Buccastem is an anti-sickness tablet which may be taken alongside painkillers or a different type of migraine treatment. There are other types of anti-sickness medicines (Anti-emetics) which work in a similar way to Buccastem. These include: 

• Domperidone 

• Metoclopramide 

• Stemetil

Stemetil also contains Prochlorperazine. It's essentially the same medicine as Buccastem except it comes in tablet, syrup and injection form instead of dissolving in the mouth. 

How to cope with migraines

The best thing to do when you experience a migraine attack is to lie down in a dark room until it passes. Painkillers need to be taken early on during a migraine to give them time to work. Keeping a migraine diary to record your symptoms can help get an accurate diagnosis from your doctor and identity possible triggers and environmental factors which may be causing your migraines. Record as many details as you can so that you can avoid triggers and manage your migraines better. There is also preventative medication available for frequent migraine sufferers. 

How to prevent migraines

The best way to prevent a migraine is to identity what is triggering them so that you can take steps to avoid it. Keeping a diary to record where and when your migraines take place, what environmental factors were present and anything you had eaten and drank will all help to find a pattern. In addition to this, you should drink plenty of water to stay hydrated and get enough exercise to stay healthy.  

Sources

Patient Information Leaflet https://www.medicines.org.uk/emc/product/478/pil

Net Doctor> Buccastem M (Prochlorperazine) https://www.netdoctor.co.uk/medicines/digestion/a8334/buccastem-m-prochlorperazine/

The Migraine Trust> Acute Medicines https://www.migrainetrust.org/living-with-migraine/treatments/acute-medicines/

NHS> Migraines https://www.nhs.uk/conditions/migraine/

UCI Health> When You Should Worry About Your Headache http://www.ucihealth.org/blog/2017/07/migraines

The Migraine Trust> Types of Migraine https://www.migrainetrust.org/about-migraine/types-of-migraine/

The Migraine Trust> More Than Just A Headache https://www.migrainetrust.org/about-migraine/migraine-what-is-it/more-than-just-a-headache/