Sumatriptan and zolmitriptan are to be down-scheduled to over-the counter (OTC) medicines to allow pharmacists to diagnose migraine and dispense the medications for people in the early stages of an attack.
In an interim decision the TGA’s Advisory Committee on Medicines Scheduling has approved a proposal for retail pharmacies to provide two tablets of sumatriptan or zolmitriptan for the acute relief of migraine attacks with or without aura in patients who have a stable, well-established pattern of symptoms.
The rescheduling from S4 (prescription only medicine) to S3 (pharmacist only medicine) will take effect from February 2021 and will also allow the advertising of the triptan direct to consumers.
In its decision summary, the committee said it accepted the rationale that timely access to a triptan via a pharmacy would be beneficial, since they need to be taken within an hour of the onset of migraine headache – and this is sometimes not possible if patients can not see a GP promptly to obtain a prescription for the drug.
“Delay in treatment increases the risk of more severe and prolonged headache pain, increases risk of inappropriate simple analgesic use and risk of medication overuse headache [and] increases risk of progression to chronic migraine,” the application for down-scheduling stated.
It noted that retail pharmacies regularly have migraineurs who find themselves without a supply of sumatriptan, but can only sell them OTC products such as metoclopramide + paracetamol or prochlorperazine.
“Further, the already available products under Schedule 3 for symptomatic treatment of migraine headaches largely aim to relieve nausea or vomiting associated with the headache, with paracetamol possibly only offering some relief against the headache itself.