An antimigraine agent - It is used to treat vascular headaches or migraines
FDA Alerts
Possible serious and/or life-threatening cerebral and/or peripheral ischemia when administered concomitantly with potent CYP3A4 inhibitors (see Interactions); concomitant use contraindicated.
Prevention or abortion of vascular headaches (e.g., migraine, cluster headaches), when used alone or in fixed combination with caffeine. Should not be used for prophylactic or chronic daily management of migraine headache.
Ineffective in the treatment of muscle contraction headaches.
Vasomotor Symptoms Associated with Menopause
Amelioration of vasomotor symptoms (e.g., hot flushes, sweating, restlessness, insomnia) in menopausal women, when used in fixed combination with belladonna alkaloids and phenobarbital.
Other Uses
Used for its autonomic effects in the treatment of various cardiovascular and GI disorders (when given in fixed combination with belladonna alkaloids and phenobarbital); generally has been replaced by more specific agents for these uses.
Dosage and Administration
General
Vascular Headaches
Administer as soon as possible after onset of first symptoms of vascular headache.
After administering the initial dose, patient should lie down and relax in a quiet, darkened room.
Dosage adjustments may be required when administered concomitantly with other drugs used in the treatment of vascular headaches. (See Specific Drugs under Interactions.)
Administration
Administer orally or rectally (as fixed-combination preparation containing ergotamine and caffeine) for the treatment of vascular headaches.
Administer orally (as fixed-combination preparation containing ergotamine, levorotatory alkaloids of belladonna, and phenobarbital) for the treatment of vasomotor symptoms of menopause.
Administer sublingually (as single-entity preparation) for the treatment of vascular headaches.
Oral Administration
Administer fixed-combination preparation containing ergotamine, levorotatory alkaloids of belladonna, and phenobarbital twice daily (morning and evening).
Sublingual Administration
Place tablets under the tongue and allow to dissolve.
Rectal Administration
If suppositories become softened, chill them in ice-cold water to solidify before removing the foil wrapper.
Fixed-combination ergotamine and caffeine (e.g., Cafergot®) tablets: 2 mg (2 tablets) initially, followed by 1 mg at 30-minute intervals until attack has abated (maximum 6 mg per attack).
Sublingual
Ergotamine tartrate (Ergomar®) tablets: 2 mg (1 tablet) initially, followed by 2 mg at 30-minute intervals until attack has abated (maximum 6 mg per 24-hour period).
Rectal
Fixed-combination ergotamine and caffeine (e.g., Cafergot®) suppositories: 2 mg (1 suppository) initially. If necessary, may give a second 2-mg dose in 1 hour.
In some patients with cluster headaches in the morning, 2–4 mg (1–2 suppositories) may be given at bedtime on a short-term basis.
Vasomotor Symptoms Associated with Menopause
Oral
Fixed-combination ergotamine, levorotatory alkaloids of belladonna, and phenobarbital (e.g., Bellamine® S) tablets: 0.6 mg (1 tablet) twice daily (morning and evening).
Prescribing Limits
Adults
Vascular Headaches
Oral
Maximum 6 mg (6 Cafergot® tablets) per attack or 10 mg (10 Cafergot® tablets) per week.
Sublingual
Maximum 6 mg (3 Ergomar® tablets) per 24-hour period or 10 mg (5 Ergomar® tablets) per week.
Rectal
Maximum 4 mg (2 Cafergot® suppositories) per attack or 10 mg (5 Cafergot® suppositories) per week.
FDA Alerts
Drug Info Tools
