What is this medication for?
Dihydroergotamine is used to help relieve the pain of migraine headaches.
Dihydroergotamine belongs to a family of medicines called ergot alkaloids.
These medications work by constricting blood vessels in the head. This relieves
the dilation (widening) of blood vessels, which is related to migraine headache
pain.
Dihydroergotamine is most effective if taken at the first sign of a migraine
headache. It is not effective for other types of headache or to prevent headaches
from occuring. Relief is often obtained within one-half hour of taking the medication.
Extra medication may be given if some relief is not obtained after the initial
dose. (See the following section for maximum doses.)
Your doctor may have suggested this medication for conditions other than those
listed here. As well, some forms of this medication may not be used for all
of the conditions discussed here. If you have not discussed this with your doctor
or are not sure why you are taking this medication, speak to your doctor. Do
not give this medication to anyone else, even if they have the same symptoms
as you do. It can be harmful for people to take this medication if their
doctor has not prescribed it. Do not stop taking this medication without
consulting your doctor.
What form(s) does this medication come in?
Migranal® is available as:
Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.
How should I use this medication?
This medication is intended for nasal use and must not be injected.
The recommended dose of dihydroergotamine is one spray in each nostril (total
of 2 sprays) at the first sign or symptom of a migraine headache, or as early
as possible after the onset of headache pain. If the headache has not improved
sufficiently after about 15 minutes, one additional spray can be used in each
nostril (total of 2 sprays). One bottle of dihydroergotamine nasal spray contains
4 sprays. No more than 4 sprays (2 in each nostril = 1 bottle) should be used
for any migraine attack. No more than 6 sprays (2 bottles) should be used in
any 24-hour period. No more than 8 sprays (2 bottles) should be used in any
7-day period.
The spray should be used in the following manner (see package insert for
illustrated details):
- Start to prepare the sprayer only when you have a migraine attack.
- Slowly lift and bend back the lip of the blue seal to show the rubber stopper.
Try not to break the blue seal.
- Completely remove the seal and metal collar in one piece, if possible.
If the two should break apart, carefully continue removing the metal collar.
The collar has a sharp edge - handle it with care.
- Gently pull the rubber stopper out of the bottle. Be careful not to spill
the contents.
- Gently remove the transparent plastic protective cover from the bottom
of the sprayer. Insert the sprayer into the bottle and tighten firmly onto
the bottle in a clockwise direction.
- Holding the bottle upright, gently remove the blue plastic protective cap
from the top of the sprayer.
- Pump the sprayer four times in the air to prime it.
- Hold your head straight. (Do not tilt your head back.)
- Insert the sprayer into one of your nostrils and pump the sprayer once
to release the medication.
- Repeat in the other nostril (a total of 2 sprays).
- Don't blow your nose. Don't sniff while spraying this medication or immediately
afterward.
- Wait about 15 minutes. For best results and long-lasting relief, or if you have not already experienced sufficient relief,
repeat the spray once
in each nostril. Discard the bottle and sprayer after use.
- Lying down in a quiet, dark room for a while after you use this medication
may help with your treatment.
It is important that this medication be taken exactly as prescribed by your
doctor. Do not take a double dose to make up for a missed one.
Store this medication at room temperature, and keep it out of the reach of
children.
Who should NOT take this medication?
Dihydroergotamine should not be used by anyone who:
- anyone allergic to any of the ingredients
- anyone who has recently undergone vascular surgery (surgery of blood vessels)
- anyone who has used ergotamine drugs (methysergide or ergotamine) or serotonin
agonists (eg., sumatriptan) within the previous 24 hours
- anyone with angina (chest pain), including Prinzmetal's variant angina
- anyone with diseases of the circulation (peripheral vascular disease)
- anyone with hemiplegic or basilar migraine
- anyone with ischemic heart disease (a heart attack or silent ischemia [damage
to the heart without symptoms])
- anyone with sepsis (severe blood infection)
- anyone with severely impaired liver or kidney function
- anyone with uncontrolled or severe high blood pressure
- pregnant or breast-feeding women