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Dihydroergotamine Generic Name & Formulations
Legal Class
Rx
General Description
Dihydroergotamine mesylate 1mg/mL; for IM, IV, or SC inj.
Pharmacological Class
Ergot alkaloid.
How Supplied
Contact supplier
Manufacturer
Dihydroergotamine Indications
Indications
Acute treatment of migraine headache or cluster headache episodes.
Dihydroergotamine Dosage and Administration
Adult
1mL IV at 1 hour intervals; max 2 doses/day. Or, 1mL IM or SC at 1-hour intervals; max 3 doses/day. For all: max 6 doses/week. Do not use chronically.
Children
Not established.
Dihydroergotamine Contraindications
Contraindications
Ischemic heart disease. Coronary artery vasospasm (eg, Prinzmetal's angina) or myocardial ischemia. Peripheral artery disease. Sepsis. Post-vascular surgery. Uncontrolled hypertension. Other significant cardiovascular disease. Severely impaired hepatic or renal function. Basilar or hemiplegic migraine. Concomitant potent CYP3A4 inhibitors (eg, ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin, troleandmycin, ketoconazole, itraconazole) or other vasoconstrictors. Within 24 hours of sumatriptan, zolmitriptan, other 5-HT1 agonists, or ergot-type drugs.
Dihydroergotamine Boxed Warnings
Boxed Warning
Peripheral ischemia following coadministration with potent CYP3A4 inhibitors.
Dihydroergotamine Warnings/Precautions
Warnings/Precautions
Confirm diagnosis. Exclude underlying cardiovascular disease, supervise 1st dose, and consider monitoring ECG in patients with likelihood of unrecognized coronary disease (eg, postmenopausal women, men over age 40, hypercholesterolemia, hypertension, obesity, diabetes, smokers, strong family history). Monitor cardiovascular function in long-term intermittent use. Compromised circulation. Medication overuse headache. Elderly. Pregnancy: avoid. Nursing mothers: not recommended (during and for 3 days after the last dose).
Dihydroergotamine Pharmacokinetics
Elimination
Fecal. Half-life: ~9 hours.
Dihydroergotamine Interactions
Interactions
See Contraindications. Potentiated by CYP3A4 inhibitors (eg, protease inhibitors, macrolides, azole antifungals, saquinavir, nefazodone, fluoxetine, fluvoxamine, grapefruit juice, zileuton), propranolol, nicotine.
Dihydroergotamine Adverse Reactions
Adverse Reactions
Numbness, pain, weakness of extremities, epigastric distress, tachycardia or bradycardia, nausea, vomiting, localized edema and itching, cardiac or cerebrovascular events; myocardial and peripheral vascular ischemia or vasoconstriction (ergotism: discontinue if occurs); rare: fibrotic complications.
Dihydroergotamine Clinical Trials
See Literature
Dihydroergotamine Note
Notes
Formerly known under the brand name D.H.E. 45.
Dihydroergotamine Patient Counseling
See Literature
