Examples

Generic Name	Brand Name
dihydroergotamine	Migranal
ergotamine with caffeine	Cafergot, Migergot

How It Works

Ergotamines narrow (constrict) blood vessels in the brain. It is not clear how they work to stop a migraine. These medications are available in different forms depending on the drug, but include tablets, nasal spray, and injections.

Why It Is Used

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

How Well It Works

Ergotamines have been used for many years to treat headache pain and other symptoms associated with migraines. But these medicines may not be as effective as other migraine medicines, such as triptans.¹

Dihydroergotamine can be effective in some people who do not get relief from triptans.¹

Side Effects

Side effects of ergotamines, 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).

Dihydroergotamine causes fewer side effects than ergotamine. It can cause diarrhea.

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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References

Citations

1. Drugs for migraine (2008). Treatment Guidelines From The Medical Letter, 6(67): 17–22.