DIHYDROERGOTAMINE

GENERIC NAME: Dihydroergotamine

PHARMACOLOGICAL CLASS: Ergot Derivatives
ATC CODE: N02CA01
PRACTICE INSIGHTS:

Serious and/or life-threatening peripheral ischemia has been reported with

coadministration of this drug with potent CYP 3A4 inhibitors

DOSE
ADULT:
Migraine & Cluster Headaches
IV/IM/SQ

1 mgq1hr if needed
Maximum dose 2 mg IV or 3 mg IM/SC per 24-hr period
Maximum dose 6 mg qWeek

PEDIATRIC:

Safety and efficacy not established

DOSE ADJUSTMENT
Hepatic impairment

No dosage adjustment provided in manufacturers labeling

Renal impairment

No dosage adjustment provided in manufacturers labeling

INDICATIONS (OPTIONAL):
PREGNANCY & LACTATION:

Category X
Enters breast milk/not recommended

MODE OF ACTION:
ADVERSE DRUG REACTIONS:
Frequency not defined

Cerebrovascular disease, dizziness, ergotism , nasal irritation, nausea,

paresthesia, peripheral ischemia , tachycardiataste sense altered, nasal spray, throat
irritation, vomiting
DRUG INTERACTIONS:
CONTRAINDICATIONS & WARNINGS:

Contraindicated in
o Hypersensitivity
o Peripheral vascular disease

o Severe hepatic/renal impairment

o

Ischemic heart disease

Uncontrolled hypertension

o Sepsis
o

Pregnancy

Breastfeding women

o Recent vascular surgery

o Hemiplegic or basilar migraine
o Coadministration with potent CYP3A4 inhibitors
o Peripheral or central vasoconstrictors

Risk of
Coronary vasospasm
Use caution in
Unrecognized CAD

DIETARY & GENERAL CONSIDERATIONS:

Advise patient avoid eating grapefruit or drinking grapefruit juice while taking
dihydroergotamine.

MONITORING PARAMETERS:

Monitor:
o BP
o RFT
o LFT