APPI-D syrup contains pizotifen (as maleate) which is an antiserotonin that
can be used for prophylaxis from migraine and prevention of headache attack
during cluster period but it is non effective in treatment of acute attack.

A- Do not takes APPI-D:
• Do not use this medication if you are allergic to pizotifen or any component of this drug.
• If the migraine has been started.
• If you are taking drugs containing monoamine oxidase inhibitors (MAOIs).
• APPI-D should not be used for children's below 2 years.
• If you are breastfeeding
B- Take special care with APPI-D:
Check with your physician or pharmacist before using this medicine if:
• You have glaucoma.
• You have kidney or liver disease.
• If you having a history of epilepsy.
• If you have any dysfunction leading to urine retention like enlarged prostate gland.
• If you are alcoholic.
C-Taking other medicines, herbal or dietary supplements
• Alpha or beta blockers may interact with pizotifen.
• Sedatives, antihistamines and alcohol may increase sleeping effect of pizotifen.
• Drugs that lowering blood pressure (guanethidine) may interact with pizotifen.
Please tell your physician or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without prescription.
D-Taking APPI-D with food and drink
APPI-D syrup can be taken with or without food.
E- Pregnancy:
Ask your physician or pharmacist for advice before taking any medicine.
Limited data about effect of pizotifen in pregnancy available. APPI-D is only recommended for use during pregnancy when benefit outweighs risk.
F- Breastfeeding:
There are no data about the excretion of pizotifen in human milk. APPI-D is not recommended to use during breastfeeding.
Ask your physician or pharmacist for advice before taking any medicine.
G- Driving and using machines:
APPI-D may cause drowsiness and dizziness. If this happens, you should not drive or operating machines.
H- Important information about some of the ingredients of APPI-D:
APPI-D syrup contains:
• E216 and E218 that may cause allergic reactions.
• E420 that may cause a mild laxative effect in patients with fructose intolerance (hereditary problem).

Always take APPI-D syrup exactly as your physician has told you.

You should check with your physician or pharmacist if you are not sure.
Dosage
Your physician will determine what dose is appropriate for you.
Adults
• The usual dose for adults is 1.5 mg of pizotifen each day (This is 30 ml).
• You may have been told to take your medicine once a day or you may have it split into three smaller doses.
• Do not take more than 3 mg (This is 60 ml) in a single dose. Do not take more than 4.5 mg (This is 90 ml) in a day.
Children (aged over 2 years)
• Children can take up to 1.5 mg of pizotifen each day (This is 30 ml).

• This is usually best given in two or three smaller doses.
• Do not give them more than 1 mg in a single dose (This is 20 ml).
A- If you take more APPI-D than you should:
Call your physician or go to the nearest hospital emergency unit immediately.
Overdose: some symptoms may observe like: nausea, drowsiness, hypotension, deep sleep, respiratory depression, slight dulling of senses and convulsions.
B- If you forget to take APPI-D:
If you forget to take a dose, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
C- If you stop taking APPI-D SYRUP:
Do not stop taking APPI-D unless your physician tells you to.
If you have any further questions on the use of this medicine, ask your physician or pharmacist.

Like all medicines, APPI-D can cause side effects, although not everybody gets them.
Tell your physician immediately if you experience any of the following
symptoms:
APPI-D may cause some of the following side effects:
• Allergic reactions such as itching, rashes or hives on the skin or face oedema.
• Increase in appetite may lead to an increase in bodyweight.
• Dizziness, sedation, drowsiness, tiredness, nausea and dry mouth.
• Constipation and gastric upsets.
• Insomnia, anxiety, tingling or numbness of the hands or feet, muscle or joint pain.
• Excitability and sleep disturbances.
• Depression, convulsions and hallucinations.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your physician or pharmacist

Keep out of reach and sight of children.
Store below 30 ˚C.
To be used within one month after first opening.
Store in the original container.
Do not use the medicine after the expiry date which is stated on the box.
The expiry date refers to the last day of that month.
Do not use the medicine if you notice any visible signs of deterioration.
Medicines should not be disposed of via wastewater or household waste.
Ask your pharmacist how to dispose of medicines no longer required.
These measures will help to protect the environment.