Dihydroergotamine Injection and Nasal Spray

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Do not take dihydroergotamine if you are taking any of the following medications: antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir); or macrolide antibiotics such as clarithromycin (Biaxin), erythromycin (E.E.S., E-Mycin, Erythrocin), and troleandomycin (TAO). [More...]
Why is this medication prescribed?
Dihydroergotamine is used to treat migraine headaches. Dihydroergotamine is in a class of medications called ergot alkaloids. It works by tightening blood vessels in the brain and by stopping the release of natural substances in the brain that cause swelling.

How should this medicine be used?
Dihydroergotamine comes as a solution to inject subcutaneously (under the skin) and as a spray to be used in the nose. It is used as needed for migraine headaches. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use dihydroergotamine exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Dihydroergotamine can damage the heart and other organs if it is used too often. Dihydroergotamine should be used only to treat a migraine that is in progress. Do not use dihydroergotamine to prevent a migraine from beginning or to treat a headache that feels different than your usual migraine. Dihydroergotamine should not be used every day. Your doctor will tell you how many times you may use dihydroergotamine each week.

You may receive your first dose of dihydroergotamine in your doctor's office so that your doctor can monitor your reaction to the medication and be sure that you know how to use the nasal spray or administer the injection correctly. After that, you may spray or inject dihydroergotamine at home. Be sure that you and anyone who will be helping you inject the medication read the manufacturer's information for the patient that comes with dihydroergotamine before using it for the first time at home.

If you are using the solution for injection, you should never reuse syringes. Dispose of syringes in a puncture resistant container. Ask your doctor or pharmacist how to dispose of the puncture resistant container.

To use the solution for injection, follow these steps: To use the nasal spray, follow these steps:
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?
Before using dihydroergotamine,
What special dietary instructions should I follow?
Talk to your doctor about drinking grapefruit juice while taking this medicine.

What side effects can this medication cause?
Dihydroergotamine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away. Most of these symptoms, especially those that affect the nose, are more likely to occur if you use the nasal spray: Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: Dihydroergotamine may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at] or by phone [1-800-332-1088].

What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not refrigerate or freeze. Throw away unused medication for injection 1 hour after you open the ampule. Throw away unused nasal spray 8 hours after you open the ampule. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:
What other information should I know?
Keep all appointments with your doctor. Your doctor may order certain tests to check your body's response to dihydroergotamine.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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© 2014. The American Society of Health-System Pharmacists, Inc.
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