The use of an isopyrine-phenylbutazone compound in migraine

A randomized double-blind study of 40 patients with migraine attacks was carried out to compare an intravenous injection of isopyrine 240 mg plus phenylbutazone 130 mg (Tomanol; Byk-Gulden) with a placebo. Isopyrine is an analgesic with a central sedative action which potentiates the action of phenylbutazone, an inhibitor of prostaglandin biosynthesis and circulation. In 15 patients who received the drug the migraine attack was terminated within 5 minutes of administration, apart from a mild residual headache in 2 cases. No recurrence was reported after 24 hours. The placebo administered to 25 patients gave total relief in 3, a slight improvement of symptoms in 12 and had no effect in 10. Treatment with isopyrine-phenylbutazone compound was based on the immediate central analgesic and sedative action of isopyrine, and the inhibition of the vaso-active action of prostaglandins by phenylbutazone.