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Dihydroergotamine Mesylate Nasal spray

It is used to treat migraine headaches with or without aura

Generic Name: dihydroergotamine

Brand Names: Dihydroergotamine Mesylate, D.H.E. 45

There is an FDA Alert for this drug. Click here to view it.

  • Possible serious and/or life-threatening cerebral and/or peripheral ischemia when administered concomitantly with potent CYP3A4 inhibitors (see Interactions); concomitant use contraindicated.

What is this medicine?

DIHYDROERGOTAMINE (dye hye droe er GOT a meen) is part of a group of medicines called ergot alkaloids. It is used to treat migraine headaches with or without aura. It should not be used to prevent migraine headaches.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
  • chest pain or difficulty breathing
  • heart or blood vessel disease
  • high blood pressure
  • infection
  • kidney disease
  • liver disease
  • poor circulation
  • risk factors for heart disease such as smoking, high cholesterol, a family history of heart disease, or if you are postmenopausal or a male over 40 years of age
  • an unusual or allergic reaction to dihydroergotamine, ergot alkaloids, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

This medicine is for use in the nose. Follow the directions on the prescription label. This medicine is given at the first symptoms of a migraine. It is not for everyday use. You must prepare the nasal spray only when you are ready to use it. Follow the instructions that come with your prescription or contact your doctor or health care professional if you are unsure how to do this. Throw away the sprayer after completing the full dose. Each unit is only good for eight hours once opened. Do not use this medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

This does not apply; this medicine is not for regular use.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
  • antifungal drugs like fluconazole, itraconazole, ketoconazole or voriconazole
  • certain antibiotics like erythromycin, clarithromycin, and troleandomycin
  • cocaine
  • conivaptan
  • dexfenfluramine
  • ephedrine
  • feverfew
  • grapefruit juice
  • imatinib
  • isoproterenol
  • medicines called nitrates like isosorbide and nitroglycerin
  • medicines for colds, flu, or breathing difficulties like phenylephrine and pseudoephedrine
  • medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan
  • midodrine
  • nefazodone
  • other ergot alkaloids like bromocriptine, cabergoline, dihydroergotamine, ergoloid mesylates, ergonovine, methylergonovine, and methysergide
  • some medicines for HIV

This medicine may also interact with the following medications:

  • clotrimazole
  • fluoxetine
  • fluvoxamine
  • medicines for high blood pressure, especially beta-blockers
  • metronidazole
  • nicotine
  • zileuton

What should I watch for while using this medicine?

Check with your doctor or health care professional if you do not get relief from your headaches after using this medicine. You may need to be changed to a different kind of medicine to treat your migraines.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. To reduce dizzy or fainting spells, do not sit or stand up quickly, especially if you are an older patient. Alcohol can increase drowsiness, dizziness and flushing. Avoid alcoholic drinks.

This medicine decreases the circulation of blood to your skin, fingers, and toes. You may get more sensitive to the cold. Elderly patients are more likely to feel this effect. Dress warmly and avoid long exposure to the cold.


Last Updated: April 07, 2009
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