What is caffeine and ergotamine?
Caffeine and ergotamine both cause vasoconstriction (narrowing) of arteries and veins that supply blood to the head. Caffeine and ergotamine is used to prevent and to treat vascular headaches such as migraine and migraine-like headaches. Caffeine and ergotamine may also be used for purposes other than those listed in this medication guide.
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What are the possible side effects of caffeine and ergotamine?
Stop taking caffeine and ergotamine and seek emergency medical attention or contact your
doctor immediately if you experience.
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an allergic reaction (difficulty breathing; closing of the throat;
swelling of the lips, tongue, or face; or hives);
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chest pain;
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numbness or tingling in the fingers or toes;
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muscle pain in the arms or legs;
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leg weakness;
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changes in heart rate;
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swelling; or
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itching.
Other, less serious side effects may also occur. Continue to take caffeine
and ergotamine and talk to your doctor if you experience nausea or vomiting.
Caffeine and ergotamine may be habit forming when used for long periods of time. Larger
doses may be needed for headache relief, and withdrawal effects may occur when caffeine and
ergotamine therapy is stopped.
Side effects other than those listed here may also occur. Talk to your doctor about any side
effect that seems unusual or that is especially bothersome.
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How should I take caffeine and ergotamine?
Take caffeine and ergotamine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. Take caffeine and ergotamine at the first sign of an attack. For the oral tablets, two tablets should be taken at the first sign of a vascular headache; followed by one additional tablet every half hour if needed, up to six tablets per attack. Use the rectal suppositories as directed by your doctor. One suppository should be administered at the first sign of a vascular headache; followed by one additional suppository after one hour if needed, up to two suppositories per attack.
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What is the most important information I should know about caffeine and ergotamine?
Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with caffeine and ergotamine. In rare but severe cases, gangrene or other serious problems can result. Some, but not all, of these medications are listed below in the section "What other drugs will affect caffeine and ergotamine?". Do not take any other medications during treatment with caffeine and ergotamine without first talking to your doctor. Contact your doctor immediately if you experience numbness or tingling in the fingers or toes, chest pain, weakness of the legs, muscle pain in the arms or legs, pain in the chest, changes in heart rate, swelling or itching.
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What happens if I miss a dose?
Since caffeine and ergotamine is taken on an as-needed basis, missing a dose is not usually a problem.
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What other drugs will affect caffeine and ergotamine?
Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with caffeine and ergotamine. In rare but severe cases, gangrene or other serious problems can result. The following drugs should not be taken with caffeine and ergotamine or should be used only under the close supervision of a doctor: another medication that contains an ergot compound such as Ergomar, D.H.E., or D.H.E. Nasal; another migraine headache medicine such as almotriptan (Axert), sumatriptan (Imitrex), zolmitriptan (Zomig), rizatriptan (Maxalt), or naratriptan (Amerge)--these medicines must not be taken within 24 hours of a dose of caffeine and ergotamine;
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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?
Caffeine-ergotamine has been assigned to pregnancy category X by the FDA. There are no studies on the placental transfer or teratogenicity of the combined product caffeine-ergotamine. Caffeine has been reported to cross the placenta and to be teratogenic in animals. Ergotamine crosses the placenta in small amounts but has not appeared to be embryotoxic in this quantity. However, prolonged vasoconstriction of the uterine vessels and/or increased myocardial tone leading to reduced myometrial and placental blood flow may have contributed to fetal growth retardation observed in animals. There are no controlled data in human pregnancy. Caffeine-ergotamine use is considered contraindicated during pregnancy.
Ergotamine is excreted into human milk. Vomiting, diarrhea and convulsions have been reported in nursing infants. Ergotamine is considered contraindicated during breast-feeding by the American Academy of Pediatrics.
Caffeine is excreted into human milk in small amounts. Adverse effects in the nursing infant are unlikely. However, irritability and poor sleep patterns have been reported in nursing infants. The amount of caffeine generally found in caffeinated beverages is considered to usually be compatible with breast-feeding by the American Academy of Pediatrics. Because caffeine is excreted into human milk and because caffeine is metabolized slowly by nursing infants, consumption of more than moderate levels of caffeine by nursing mothers is not recommended.
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What does my medication look like?
Caffeine and ergotamine is available with a prescription under several brand and generic names in tablet and rectal suppository formulations. Ask your pharmacist any questions you have about this medication, especially if it is new to you.
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What happens if I overdose?
Seek emergency medical attention. Symptoms of a caffeine and ergotamine overdose include nausea, vomiting, numbness in the fingers or toes, confusion, drowsiness, convulsions, and possibly death.
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What should I discuss with my healthcare provider before taking caffeine and ergotamine ?
Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with caffeine and ergotamine. In rare but severe cases, gangrene or other serious problems can result. Some, but not all, of these medications are listed below in the section "What other drugs will affect caffeine and ergotamine?". Do not take any other medications during treatment with caffeine and ergotamine without first talking to your doctor. Do not take caffeine and ergotamine without first talking to your doctor if you have:
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Can I stop taking the medication if I feel better?
If you are taking an analgesic for pain and you are no longer experiencing the pain you may stop using the medication. In general, pain medications are to be used on an as needed basis.
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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.
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