Ergotamines for migraine headaches

Examples

Generic Name	Brand Name
dihydroergotamine mesylate	D.H.E., Migranal (nasal spray)
ergotamine tartrate with caffeine	Cafergot
ergotamine tartrate with caffeine and diphenhydramine	Ergodryl

How It Works

Ergotamines narrow (constrict) blood vessels in the brain. Although the cause of migraines is not well understood, it may have something to do with the blood vessels in the brain. These medications are available in different forms depending on the drug, but include tablets, nasal spray, or injections.

Why It Is Used

Ergotamines may be used to stop or treat symptoms of an emerging migraine.

How Well It Works

Ergotamines can effectively reduce headache pain and other symptoms associated with migraines. However, these medications may not be as effective as other migraine medications, such as triptans.¹ Ergotamines may make migraine symptoms such as nausea and vomiting worse for some people.

Side Effects

Side effects, which are more common with high doses of these medications, may include:

• Nausea and vomiting.
• Cold, clammy hands and feet (caused by narrowing of blood vessels).
• Muscle pain.
• Dizziness, numbness, and a vague feeling of discomfort or anxiety.
• Bitter or foul taste in the mouth or throat (nasal spray only).
• Irritation or inflammation in the nose (nasal spray only).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Ergotamines should not be taken with triptans (such as Imitrex).

If you are taking an ergotamine, it is very important to follow your doctor's recommendations on when and how often to take it. Overuse of ergotamines can lead to rebound headaches. Ergotamines can also have serious reactions with other kinds of medicines. Make sure your doctor knows about all the medicines you are taking—even those you can buy without a prescription.

Ergotamines should not be used to treat people who have:

• Uncontrolled high blood pressure (hypertension).
• Cerebrovascular, cardiovascular, or peripheral arterial diseases.
• Coronary or ischemic heart disease.
• Liver (hepatic) or kidney (renal) diseases.
• Enlarged prostate.
• Bowel obstruction.
• Recent surgery.
• Glaucoma.
• A history of irregular heartbeat (arrhythmia)

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Author:	Douglas Dana Monica Rhodes	Last Updated: August 21, 2007
Medical Review:	Anne C. Poinier, MD - Internal Medicine Colin Chalk, MD, CM, FRCPC - Neurology
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