dihydroergotamine (nasal)

What is the most important information I should know about dihydroergotamine nasal?

Tell your doctor about all your other medicines. Some drugs should not be used with dihydroergotamine.

What is dihydroergotamine nasal?

Dihydroergotamine nasal is used to treat migraine headaches with or without aura in adults. Dihydroergotamine nasal will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Dihydroergotamine nasal may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using dihydroergotamine nasal?

• heart disease, angina (chest pain), blood circulation problems, coronary artery disease (clogged arteries), or a heart attack or stroke;
• uncontrolled high blood pressure;
• a serious infection called sepsis;
• vascular surgery;
• narrowing of blood vessels in the legs, arms, stomach, or kidneys (peripheral vascular disease); or
• severe liver or kidney disease.

Some drugs should not be used with dihydroergotamine. Your treatment plan may change if you also use:

• medicines that raise your blood pressure or constrict your blood vessels;
• an antibiotic such as troleandomycin, clarithromycin, or erythromycin;
• antifungal medicine such as itraconazole or ketoconazole; or
• antiviral medicine for HIV or hepatitis C.

Tell your doctor if you have ever had:

• blood circulation problems in your arms, hands, legs, or feet;
• chest pain, shortness of breath;
• risk factors for coronary artery disease (high blood pressure, high cholesterol, diabetes, menopause, smoking, family history of coronary artery disease, being overweight, being over 40 and a man); or
• liver or kidney disease.

How should I use dihydroergotamine nasal?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Your first dose may be given in a medical setting where any serious side effects can be quickly treated.

You should use dihydroergotamine as soon as your headache begins, but it may be given at any time during the migraine episode.

Before your first use, prime the nasal spray device with 4 sprays into the air, away from your face.

Trudhesa: apply one spray in each nostril then another spray in each nostril 1 hour later only if your headache comes back or if you only get some relief from your headache. Use a new nasal spray device for the second dose.

Migranal: apply one spray in each nostril followed by another spray in each nostril 15 minutes later, for a total of 4 sprays.

You may need medical tests to check your heart function.

The nasal spray vial should be thrown away 8 hours after it has been opened.

What happens if I miss a dose?

Dihydroergotamine nasal is used when needed and does not have a daily dosing schedule.

Do not use more than 2 doses of Trudhesa within 24 hours or 3 doses within 7 days.

Do not use more than 6 sprays of Migranal within 24 hours or 8 sprays within 7 days.

What happens if I overdose?

Overdose symptoms may include slow breathing, blood pressure changes, confusion, hallucinations, agitation, convulsions, coma, nausea, vomiting, stomach pain, and pain, numbness, cold feeling, or pale appearance of your fingers or toes.

What should I avoid while using dihydroergotamine nasal?

• another ergot medicine such as ergotamine, ergonovine, methylergonovine; or
• almotriptan, eletriptan, frovatriptan, naratriptan, sumatriptan, or rizatriptan.

Grapefruit may interact with dihydroergotamine nasal and cause side effects. Avoid consuming grapefruit products.

What are the possible side effects of dihydroergotamine nasal?

• numbness, cold feeling, or pale appearance of your fingers or toes;
• sudden or severe stomach pain, weight loss, nausea, vomiting, constipation, bloody diarrhea, fever;
• severe headache, blurred vision, pounding in your neck or ears;
• burning sensation in the nose, mouth, throat, and altered sense of taste;
• fast or slow heart rate;
• swelling or itching;
• signs of a blood clot --sudden numbness or weakness on one side of the body, chest pain, problems with vision or speech, pain or swelling in one leg; or
• heart attack symptoms --chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating.

Common side effects may include:

• pain, bruising, swelling, or irritation where the medicine was applied;
• drowsiness;
• dizziness;
• nausea, vomiting, diarrhea;
• runny nose;
• altered sense of taste; or
• sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect dihydroergotamine nasal?

Tell your doctor about all your current medicines. Many drugs can affect dihydroergotamine, especially:

• heart or blood pressure medication;
• nicotine gum or patches;
• an antidepressant; or
• medicine to treat asthma.

This list is not complete and many other drugs may affect dihydroergotamine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your doctor or pharmacist can provide more information about dihydroergotamine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2023 Cerner Multum, Inc. Version: 5.01. Revision date: 7/20/2023.