What is Ergotamine?

Ergotamine is in a group of drugs called ergot alkaloids (ER-got AL-ka-loids). It works by narrowing the blood vessels around the brain. Ergotamine also affects blood flow patterns that are associated with certain types of headaches.
Ergotamine is used to treat a migraine type headache.
This medication will only treat a headache that has already begun. It will not prevent migraine headaches or reduce the number of attacks.
Ergotamine should not be used to treat common tension headaches or any headache that seems to be different from your usual migraine headaches.
Ergotamine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Ergotamine?

This medication can harm an unborn baby or a nursing baby. Do not take ergotamine if you are pregnant or breast-feeding.
Do not take this medication if you are allergic to ergotamine or other ergot medicines, or if you have a history of heart disease, angina (chest pain), blood circulation problems, history of a heart attack or stroke, coronary artery disease, uncontrolled high blood pressure, severe liver or kidney disease, or a serious infection.
Using certain medications together with ergotamine can cause even greater decreases in blood flow than ergotamine used alone. A severe decrease in blood flow to the brain and other parts of the body can lead to dangerous side effects. Tell your doctor about all other medications you are using, especially antibiotics, antidepressants, heart or blood pressure medications, or medicines to treat HIV or AIDS.
Also tell your doctor about all of your medical conditions, especially high blood pressure, liver or kidney disease, or risk factors for coronary artery disease (diabetes, high blood pressure or cholesterol, menopause or hysterectomy, smoking, taking birth control pills, being overweight, having a family history of coronary artery disease, or being a man older than 40).
This medication will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.
Never take more than your prescribed dose of ergotamine. Tell your doctor if the medicine seems to stop working as well in treating your migraine attacks. An overdose of ergotamine can be fatal.

What should I discuss with my healthcare provider before taking Ergotamine?

Do not take this medication if you are allergic to ergotamine or other ergot medicine such as caffeine and ergotamine (Cafergot, Ercaf, Wigraine), dihydroergotamine (D.H.E. 45, Migranal), ergonovine (Ergotrate), methylergonovine (Methergine), or methysergide (Sansert).
Do not take ergotamine if you are pregnant or breast-feeding, or if you have:

a history of heart disease, angina (chest pain), blood circulation problems, or history of a heart attack or stroke
coronary artery disease or “hardening of the arteries”
uncontrolled high blood pressure
severe liver disease
severe kidney disease; or
a serious infection called sepsis

Using certain medications together with ergotamine can cause even greater decreases in blood flow than ergotamine used alone. A severe decrease in blood flow to the brain and other parts of the body can lead to dangerous side effects. Do not take ergotamine if you are also using any of the following medications:

conivaptan (Vaprisol)
diclofenac (Arthrotec, Cataflam, Voltaren, Flector Patch, Solareze)
imatinib (Gleevec)
isoniazid (for treating tuberculosis)
an antibiotic such as clarithromycin (Biaxin), clotrimazole (Mycelex Troche), dalfopristin/quinupristin (Synercid), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), itraconazole (Sporanox), ketoconazole (Nizoral), telithromycin (Ketek), or troleandomycin (Tao), voriconazole (Vfend)
an antidepressant such as nefazodone
heart or blood pressure medication such as diltiazem (Cardizem, Dilacor, Tiazac), nicardipine (Cardene), quinidine (Quinaglute, Quinidex, Quin-Release), or verapamil (Calan, Covera, Isoptin, Verelan); or
HIV/AIDS medicine such as amprenavir (Agenerase), atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase, Fortovase), or ritonavir (Norvir)

Ergotamine can cause rare but serious side effects on the heart, including heart attack or stroke. If you have certain conditions, you may need a dose adjustment or special tests to safely take this medication. Before taking ergotamine, tell your doctor if you have:

high blood pressure
liver disease
kidney disease; or
coronary artery disease (or risk factors that include diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy)

FDA pregnancy category X. This medication can cause birth defects. Do not take ergotamine if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are taking ergotamine.
Ergotamine passes into breast milk and may be harmful to a nursing infant. Do not take ergotamine without telling your doctor if you are breast-feeding a baby.

Ergotamine Side Effects

What are the possible side effects of Ergotamine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop taking ergotamine and call your doctor at once if you have a serious side effect such as:

sudden numbness or weakness, especially on one side of the body
sudden headache, confusion, problems with vision, speech, or balance
fast or slow heart rate
muscle pain in your arms or legs
leg weakness
numbness or tingling and a pale or blue-colored appearance in your fingers or toes
severe pain in your stomach or lower back
urinating less than usual or not at all
swelling or itching in any part of your body
cough with stabbing chest pain and trouble breathing; or
dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure)

Less serious side effects may include:

dizziness, spinning sensation
weakness
nausea, vomiting; or
mild itching

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Ergotamine Interactions

What other drugs affect Ergotamine?

Many drugs can interact with ergotamine. Below is just a partial list. Talk with your doctor before taking ergotamine if you are also taking:

birth control pills
zileuton (Zyflo)
cold or allergy medications
nicotine (Nicoderm, Nicorette)
diet pills, stimulants, or medication to treat ADHD (such as Ritalin or Adderall)
an antidepressant such fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), nefazodone (Serzone), paroxetine (Paxil), sertraline (Zoloft), and others
an antibiotic such as clotrimazole (Mycelex Troche), metronidazole (Flagyl), fluconazole (Diflucan)
nitroglycerin or other nitrate medicines such as isosorbide (Isordil, Dilatrate, Imdur, Monoket); or
heart or blood pressure medication such as atenolol (Tenormin), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others

This list is not complete and there may be other drugs that can interact with ergotamine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

What should I avoid while taking Ergotamine?

Do not take ergotamine within 24 hours before or after using another migraine headache medicine, including:

dihydroergotamine (D.H.E. 45, Migranal), caffeine and ergotamine (Cafergot, Ercaf, Wigraine), ergonovine (Ergotrate), methylergonovine (Methergine), methysergide (Sansert); or
almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), sumatriptan (Imitrex), rizatriptan (Maxalt, Maxalt-MLT), or zolmitriptan (Zomig)

Grapefruit and grapefruit juice may interact with ergotamine and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Ergotamine Dosage

How should I take Ergotamine?

Take this medication exactly as prescribed by your doctor. Never take more than your prescribed dose of ergotamine. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in treating your migraine attacks. Ergotamine is not for daily use.
Take the first dose of ergotamine as soon as you notice headache symptoms, or after an attack has already begun. Place 1 ergotamine tablet under your tongue.
If your headache does not completely go away, you may take a second tablet after at least 30 minutes have passed, and a third tablet if needed after another 30 minutes have passed (a total of 3 tablets).
If you still have migraine symptoms after taking a total of 3 tablets, call your doctor. Do not take more than a total of 3 tablets in any 24-hour period. Do not take more than a total of 5 tablets over a period of 7 days.
Do not give this medication to anyone else, even if they have the same headache symptoms you have. Ergotamine can be dangerous if it is used to treat headache in a person who has not been diagnosed by a doctor as having true migraine headaches.
Store ergotamine at room temperature away from moisture, heat, and light. Do not take any stored ergotamine if the expiration date on the label has passed.

What happens if I overdose on Ergotamine?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of ergotamine can be fatal.
Overdose can cause vomiting, confusion, drowsiness, weak pulses in your arms and legs, numbness and tingling or pain in your hands or feet, blue-colored fingers or toes, fainting, and seizure (convulsions).

What happens if I miss a dose of Ergotamine?

Since ergotamine is taken only when needed, you are not likely to miss a dose.
Do not take more than 3 ergotamine tablets per day or more than 5 tablets per week.
Sourced from everydayhealth.com

Ergotamine