$Unique_ID{BRK03145} $Pretitle{} $Title{ergotamine} $Subject{Ergostat Parke-Davis Medihaler Ergotamine 3M vasoconstrictor Antimigraine migraine cluster headaches increase diameter blood vessels head flow pressure pain constricting narrowing} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. ergotamine ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Ergostat (Parke-Davis) Medihaler Ergotamine (3M) TYPE OF DRUG Antimigraine (vasoconstrictor) INGREDIENT ergotamine DOSAGE FORMS Sublingual tablets (2 mg) Aerosol (0.36 mg per spray) STORAGE This medication should be stored at room temperature in tightly closed, light-resistant containers. The container of the aerosol is pressurized; it should, therefore, never be punctured or broken. It should also be stored away from heat and direct sunlight. USES This medication is used to treat migraine and cluster headaches. These headaches are thought to be caused by an increase in the diameter of the blood vessels in the head, which results in increased blood flow, increased pressure, and pain. Ergotamine is a vasoconstrictor; it acts by constricting (narrowing) the blood vessels. TREATMENT Take this medication as soon as you notice your migraine headache symptoms. If you wait until the headache is severe, the drug takes longer to work and may not be as effective. After you take either of these forms of ergotamine, you should try to lie down in a quiet, dark room for at least two hours (in order to help the medication work). The drug usually takes effect in 30 to 60 minutes. It is very important that you understand how often you can repeat a dose of this medication during an attack (usually every 30 to 60 minutes for the sublingual tablets, and every five minutes for the aerosol spray) and the maximum amount of medication you can take per day (usually three sublingual tablets or six inhalations). Five is generally the maximum number of sublingual tablets and 15 is about the maximum number of inhalations that can be taken in any one-week period. CHECK WITH YOUR DOCTOR if you have any questions. The sublingual tablets should be placed under your tongue. DO NOT swallow these tablets--they are more efficiently absorbed through the lining of the mouth than from the gastrointestinal tract. Try not to eat, drink, chew, or smoke while the tablet is dissolving. The aerosol form of this medication comes packaged with instructions for use. Read the directions carefully; if you have any questions, check with your doctor or pharmacist. The aerosol can should be shaken well just before each dose is sprayed. The contents tend to settle on the bottom of the container, so it should be shaken to disperse the medication and equalize the doses. The container provides about 60 measured sprays. If you are on prolonged treatment with this drug and you miss a dose, take it as soon as you remember. Wait four hours to take the next dose. It is very important that you consult your doctor before you discontinue using this drug. Your doctor may want to reduce your dosage gradually. SIDE EFFECTS Minor. Diarrhea, dizziness, headache, nausea, vomiting, or sensation of cold hands and feet with MILD numbness or tingling. These side effects should disappear as your body adjusts to the medication. The aerosol form of ergotamine can cause hoarseness or throat irritation. Gargling or rinsing your mouth out with water after taking the dose may help prevent this side effect. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about chest pain; coldness, numbness, pain, tingling, or dark discoloration of the fingers or toes; confusion; fluid retention; itching; localized swelling; muscle pain; severe abdominal pain and swelling; or unusual weakness. INTERACTIONS Ergotamine interacts with several other types of medications: 1. Ergotamine interacts with amphetamines, ephedrine, epinephrine (adrenaline), pseudoephedrine, erythromycin, and troleandomycin. Such combinations can lead to increases in blood pressure or increased risk of adverse reaction to ergotamine. 2. Do not drink alcoholic beverages while you are taking this medication. Since alcohol dilates (widens) the blood vessels (which are already dilated during migraine headaches), drinking will only make your headache worse. 3. Nicotine and cocaine decrease the effectiveness of ergotamine and, therefore, make the headache worse. 4. The caffeine in tea, coffee, and cola drinks also interacts with this medication. It may actually help to relieve your headache. BE SURE TO TELL YOUR DOCTOR about any medications or substances you are currently taking or using, especially any of those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to ergotamine or other ergot alkaloids (such as ergonovine or bromocriptine). * Before starting to take this medication, be sure to tell your doctor if you now have or if you have ever had heart or blood vessel disease, high blood pressure, infections, kidney disease, liver disease, or thyroid disease. * Avoid any foods to which you are allergic--they may make your headache worse. * If this drug makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous equipment. * Try to avoid exposure to cold. Since this drug acts by constricting blood vessels throughout the body, your fingers and toes may become especially sensitive. * Elderly patients are more sensitive to the effects of ergotamine. Consult your doctor if the side effects become bothersome. * This medication should not be taken for longer periods or in higher doses than recommended by your doctor. Extended use of this drug can lead to serious side effects. In addition, tolerance can develop--higher doses would be required to obtain the same beneficial effects (at the same time increasing the risk of side effects). * Be sure to tell your doctor if you are pregnant. Ergotamine can cause contractions of the uterus, which can harm the developing fetus. This drug should not be used during pregnancy. Also, tell your doctor if you are breast-feeding an infant. Ergotamine passes into breast milk and may cause vomiting, diarrhea, or convulsions in the nursing infant. MONEY-SAVING TIP Save the inhaler piece from the aerosol container. Refill units, which are less expensive, are available. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.