Dihydroergotamine



D.H.E. 45®; Migranal®







Dihydroergotamine

(dye hye droe er GOT a meen)

U.S. Brand Names
D.H.E. 45®; Migranal®
Canadian Brand Names
Migranal®
Pharmacologic Category
Ergot Derivative
What key warnings should I know about before taking this medicine?
  • This medicine does not mix well with many medicines. Serious reactions may occur. Check all medicines with healthcare provider.
Reasons not to take this medicine
  • If you have an allergy to dihydroergotamine or any other part of this medicine.
  • Tell healthcare provider if you are allergic to any medicine. Make sure to tell about the allergy and how it affected you. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other symptoms involved.
  • If you have any of the following conditions: Heart disease, kidney disease, liver disease, poor circulation, poor intestinal blood flow, recent heart attack, severe infection, or uncontrolled high blood pressure.
  • If you are taking any of these medicines: Amprenavir, clarithromycin, erythromycin, indinavir, itraconazole, ketoconazole, nelfinavir, ritonavir, or troleandomycin.
  • If you have taken isocarboxazid, phenelzine, or tranylcypromine in the last 14 days. Monoamine oxidase inhibitors (eg, isocarboxazid, phenelzine, and tranylcypromine) must be stopped 14 days before this medicine is started. Taking the two together could cause dangerously high blood pressure.
  • If you have taken almotriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, or zolmitriptan in the last 24 hours.
  • If you have taken ergotamine or methysergide in the last 24 hours.
  • If you are pregnant or may be pregnant.
  • If you are breast-feeding.
What is this medicine used for?
  • This medicine is used to treat migraine headaches.
How does it work?
  • Ergotamine squeezes certain blood vessels in the brain preventing irritation and inflammation.
How is it best taken?
  • Injection:
  • This medicine is given as a shot into a muscle, vein, or into the fatty part of the skin.
  • Your healthcare provider may teach you how to give the shot.
  • Wash hands before and after use.
  • Throw away needles in needle/sharp disposal box and return box to healthcare provider when full.
  • If you get another attack the same day, do not use unless at least 6 hours have passed since your last shot.
  • Inhalation:
  • For inhaling through the nostrils. Prime pump by squeezing it 4 times. Inhale 1 spray in each nostril. Wait 15 minutes. Inhale another spray in each nostril.
What do I do if I miss a dose? (does not apply to patients in the hospital)
  • This medicine is taken on an as needed basis.
What are the precautions when taking this medicine?
  • Check medicines with healthcare provider. This medicine may not mix well with other medicines.
  • Avoid grapefruit and grapefruit juice.
  • Avoid cigarette smoking.
  • Use caution if you have risk factors for heart disease (high blood pressure, high cholesterol, overweight, diabetes, cigarette smoking, male older than 40 years of age, other family members with early heart disease, postmenopausal female). Talk with healthcare provider.
  • Use birth control that you can trust to prevent pregnancy while taking this medicine.
What are some possible side effects of this medicine?
  • Nausea or vomiting. Small frequent meals, frequent mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help.
  • Nasal irritation.
  • Abnormal taste. This is usually reversible.
What should I monitor?
  • Change in condition being treated. Is it better, worse, or about the same?
  • Take good care of your teeth. See a dentist regularly.
  • Follow up with healthcare provider.
Reasons to call healthcare provider immediately
  • If you suspect an overdose, call your local poison control center immediately or dial 911.
  • Signs of a life-threatening reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat.
  • Change in strength on one side greater than the other, difficulty speaking or thinking, change in balance, or blurred vision.
  • Chest pain or pressure or fast heartbeat.
  • Numbness or tingling of hands or feet.
  • Severe dizziness or passing out.
  • Difficulty breathing.
  • Severe muscle pain or weakness.
  • Any rash.
  • No improvement in condition or feeling worse.
How should I store this medicine?
  • Store at room temperature. Do not freeze.
  • Once the nasal spray is prepared, throw away any unused portion of the opened ampul after 8 hours.
  • Protect injectable from light.
General statements
  • If you have a life-threatening allergy, wear allergy identification at all times.
  • Do not share your medicine with others and do not take anyone else's medicine.
  • Keep all medicine out of the reach of children and pets.
  • Keep a list of all your medicines (prescription, natural products, supplements, vitamins, over-the-counter) with you. Give this list to healthcare provider (doctor, nurse, nurse practitioner, pharmacist, physician assistant).
  • Talk with healthcare provider before starting any new medicine, including over-the-counter, natural products, or vitamins.
Brand Names: