How can you help patients break through the vicious cycle of pain-disturbed sleep?
Mersyndol acts fast to provide symptomatic relief of acute moderate to severe pain through the combined analgesic and calmative effects of paracetamol, codeine and doxylamine. 
What is Mersyndol
Mersyndol has been trusted by pharmacists and patients for over 40 years to provide symptomatic relief of acute, moderate to severe pain . The calmative action of doxylamine in Mersyndol plays an important role in enhancing the effects of analgesics and may be especially useful in the treatment of migraine. 
Pain and sleep may join in a vicious cycle
Pain can disrupt sleep [2,3] and poor sleep may lower the pain threshold which may in turn contribute to increased pain [4,5]. Mersyndol helps break this pain-sleep cycle through its calmative and analgesic properties. This powerful pain relief assists with achieving a good night’s sleep. [1,6] . And for pain sufferers, sleep is often welcomed as it may help to relieve the migraine attack. 
Migraine is a very common condition affecting more than three million people in Australia with women being three times more likely than men to suffer migraine. Pharmacists play an important role in providing pain management advice for patients including treatments available and lifestyle strategies to help them manage their migraines. One way pharmacists can help is by assisting pain patients with the creation of a pain diary. By keeping a diary, patients are able recognise what triggers their migraine and consequently try to avoid them when possible or at least prepare for future migraines. 
Precipitating factors that trigger migraine vary from person to person and include hormonal changes in women, stress, dietary factors, alcohol, environmental factors, too much or too little sleep, physical exertion, bright lights and poor work conditions. 
Along with addressing triggers, these simple measures may assist patients deal with migraine at home: 
- Lie in a quiet, cool, dark room;
- Place a cool flannel on your forehead/neck;
- Avoid coffee, tea and orange juice;
- Do not read or watch TV;
- Relaxation techniques ;
- Some people find relief from “sleeping off” an attack; and
- Don’t drive.
Supporting appropriate use of codeine
Mersyndol strongly supports the responsible use of medicines and is actively engaged in reducing the risks of codeine misuse, while ensuring patients retain appropriate access to pain relief.
Mersyndol has voluntarily included front of pack warnings, supports the ACMS proposal to implement pack size reduction and is collaborating with The Pharmacy Guild on the implementation of MedsASSIST, a real-time monitoring system for community pharmacies, designed to assist with the appropriate supply of codeine based medicines.
- Mersyndol Product Information, October 2014. 2. Drewes AMA-N, L. Sleep Res Online 2001;4(2):67-76. 3. Menefee LA et al. Pain Med 2000;1(2):156-172. 4. Kundermann B et al. Psychosom Med 2004;66(6):932-937. 5. Moldofsky H. Sleep Med Rev 2001;5(5):385-396. 6. Kelman L, Rains JC. Headache 2005;45(7):904-910. 7. Inamorato E et al. Arq Neuropsiquiatr 1993;51(4):429-432. 8. Headache Australia accessed 24 September 2015, http://headacheaustralia.org.au/migraine/migraine-a-common-and-distressing-disorder/. 9. Headache Australia accessed 24 September 2015, http://headacheaustralia.org.au/migraine/avoiding-triggers/. 10. Department of Health VIC. Migraine Emergency Department factsheet; 2010;1-2
Before recommending please review Full Product Information available from Sanofi by calling 1800 818 806
Mersyndol (paracetamol; codeine phosphate; doxylamine succinate) is indicated for symptomatic relief from acute moderate to severe pain, including tension headache and migraine, in patients >12 years. Take 1-2 tablets every 4-6 hours as needed; do not exceed 8 tablets in 24-hour period. Contraindications: Hypersensitivity to the active ingredients or any excipients, respiratory depression, G6PD deficiency, breastfeeding, CYP2D6 ultrarapid metabolisers. Precautions: High doses; prolonged use; severe hepatic or renal impairment; analgesic intolerance; asthma; lactation; use in pregnancy (Category A). Adverse effects: Anorexia, drowsiness, depression, dizziness, sweating, and others. For more information, see full PI.
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