Looks at ergotamines for cluster headaches. Lists generic and brand names such as dihydroergotamine (Migranal), ergotamine with caffeine (Cafergot, Migergot), and ergotamine (Ergomar). Covers how well they work and side effects.
Ergotamines for Cluster Headaches
ergotamine with caffeine
Dihydroergotamine can also be given through a vein (intravenous, or IV) or by an injection
in the muscle (intramuscular, or IM) for emergency treatment of a severe
How It Works
Ergotamine narrows blood vessels in the
head (vasoconstriction), which relieves pain by reducing pressure on
pain-sensitive structures in the head and scalp that may be associated with
cluster headaches. This drug may also affect certain brain
chemicals that affect how a person feels pain.
Why It Is Used
Dihydroergotamine and ergotamine are used to stop a cluster headache. Ergotamine may also be used to prevent cluster headaches during a cluster cycle.
How Well It Works
When taken at bedtime or several
hours before going to sleep, ergotamine is especially useful for preventing
headaches at night.1
The nasal spray form of dihydroergotamine can help reduce the pain of a cluster headache when used at the first sign you are getting one.2
which is typically given as a shot, may provide rapid relief of a headache. A
person may be able to give his or her own shot.
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:
Swelling of your face, lips, tongue, or throat.
Call your doctor right away if you have:
Signs of an overdose, such as:
Dizziness, weakness, or extreme drowsiness.
Severe nausea, vomiting, stomach pain, or diarrhea.
Signs of a problem with blood circulation, such as:
Fast or slow heartbeat.
Muscle pain or pain in the legs or arms.
Pale or blue-colored hands or feet.
Check with your doctor if you have:
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).
See Drug Reference for a full list of side effects.
(Drug Reference is not available in all systems.)
What To Think About
To treat a cluster headache that
has already begun, ergotamine must be used as early as possible for best
results. The sooner you treat the headache, the less painful it may be.
If you are taking ergotamine, be sure to follow your
doctor's instructions on when and how often to take it. Overuse of
ergotamine can lead to a
Ergotamine should not be used with serotonin receptor
agonists (triptans), such as naratriptan, rizatriptan, sumatriptan, or zolmitriptan.
Ergotamine should not be used to treat headaches in
children. And it should not be used in women who are pregnant or who
are thinking about becoming pregnant.
Also, ergotamine should not
be used by people who have:
Uncontrolled high blood
Cerebrovascular, cardiovascular, or
peripheral arterial diseases.
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.
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.
Ropper AH, Samuels MA (2009). Cluster headache section of Headache and other craniofacial pains. In Adams and Victor's Principles of Neurology, 9th ed., pp. 174–176. New York: McGraw-Hill.
Capobianco DJ, Dodick DW (2006). Diagnosis and
treatment of cluster headache. Seminars in Neurology,
How this information was developed to help you make better health decisions.