Ergotamines for Migraine Headaches

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 medicines are available in different forms depending on the drug, including tablets, nasal spray, suppositories, 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

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

  • Hives.
  • Signs of an overdose, such as:
    • Dizziness, weakness, or extreme drowsiness.
    • Seizures.
    • Severe nausea, vomiting, stomach pain, or diarrhea.
  • Signs of a problem with blood circulation, such as:
    • Chest pain.
    • Confusion.
    • Fast or slow heartbeat.
    • Muscle pain or pain in the legs or arms.
    • Pale or blue-colored hands or feet.
    • Vision changes.

Check with your doctor if you have:

  • Itching.
  • Tingling or weakness in fingers or toes.
  • Swelling in the feet, lower legs, or fingers.

Common side effects of this medicine include:

  • Burning, tingling, dryness or pain in the nose (nasal spray).
  • Change in the sense of taste (nasal spray).
  • Diarrhea.
  • Nausea.

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

What To Think About

Overuse of migraine drugs can cause rebound headaches. Rebound headaches are different from migraine headaches. They are usually triggered after pain medicine has worn off, prompting you to take another dose. Eventually you get a headache whenever you stop taking the drug. Be sure to take your migraine medicine only as prescribed by your doctor.

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

It's a good idea to avoid smoking or tobacco replacement products for several hours after taking these medicines. Smoking or other forms of nicotine can increase the side effects of ergotamines.

Ergotamines may make you more sensitive to cold weather. Dress warmly and if you need to, limit your time in cold weather.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Do not use this medicine if you are pregnant, breast-feeding, or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Drugs for migraine (2011). Treatment Guidelines From The Medical Letter, 9(102): 7–12.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Colin Chalk, MD, CM, FRCPC - Neurology
Last Revised June 4, 2013

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

© 1995-2013 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.