Polygot – tablets (coated) containing caffeine 0.1 g and ergotamine tartrate 0.001 g (1 mg). Polygot is used for migraine (vasoparalytic form), as well as a drug that lowers intracranial pressure in vascular, traumatic, infectious lesions of the central nervous system. The effect is due to the vasoconstrictor effect of ergotamine and improvement of cerebral function under the influence of caffeine.
It is prescribed orally on 1-2 tablets per intake during a headache attack 2 times a day, then 1 tablet 2-3 times a day for several days (up to 1 month). After oral administration, about 62% of ergotamine is absorbed in the gastrointestinal tract. Maximum plasma concentrations are achieved 2 hours after oral administration. Binding to plasma proteins is 98%. Ergotamine is metabolized in the liver to form pharmacologically active metabolites. Ergotamine is excreted mainly with bile both unchanged and as metabolites. Excretion is biphasic, with half-lives of 2.7 hours and 21 hours for I and II phases, respectively. After oral administration caffeine is absorbed quickly and almost completely. Binding with plasma proteins is 35%. Caffeine is almost completely metabolized in the body. Metabolites are excreted mainly with urine. The elimination half-life is about 3.5 hours.
One of the most common forms of headache is migraine, which affects about 13% of the population in the world, mainly women. Migraine is a very severe disease and represents a significant burden to society and, above all, to patients who suffer from frequent attacks of headache. Unlike many other types of headache, migraine is characterized by predominantly severe attacks with severe disadaptation, impaired ability to work and daily functioning. According to data of a large-scale study of the American Migraine Study II, on the days of attacks, about 53% of patients completely lose the ability to work. On average, each migraine patient loses 3.2 working days per year. The proportion of patients who have to continue working at the time of a headache attack has a more than 46% reduction in work activity. Therefore, the vast majority of patients (about 80%) have to take pain medication during almost every attack. It is for this reason that migraine headaches are the fourth most frequent reason for seeking emergency care, accounting for 1-3% of all cases. This is often due not only to severe, prolonged, or poorly manageable headaches, but also to the many unusual, difficult-to-tolerate symptoms that almost always accompany migraine pain.
There are two main strategies for treating migraine: migraine attack control and prophylactic treatment. The goals of preventive treatment are to reduce the frequency, intensity and duration of attacks, to reduce the need for headache medication, and to increase adaptation and daily functioning. Prophylactic treatment is not indicated for all patients, but only for those who suffer from frequent attacks or attacks that are accompanied by severe disadaptation, and in cases when patients themselves prefer preventive treatment. In contrast, attack control is necessary for virtually all patients, both those who have frequent attacks and those who have infrequent attacks. The goal of migraine attack control is to eliminate the headache and associated symptoms, and to prevent the possibility of pain recurrence.