Ergotamine tratrate + Caffeine

Ergotamine tratrate + Caffeine
(Antimigraine Preparations)

Dosage form	Brand	Strength
eye drop, cream , capsule, ear drop, tablet,	Avamigrain®, Cafegot®, Dergan®, Ergosia® ,Imigrain®, Migina®	Ergotamine tartrate 1 mg, caffeine 100 mg

Indication : Acute attack of migraine w/ or w/o aura.

Mechanism of action : agonist activity at the serotonin 5-HT1D receptor, resulting in vasoconstriction of intracranial blood vessels and inhibition of inflammatory neuropeptide release

Pregnancy Category X

Contraindication : Impaired peripheral circulation, obliterative vascular disease, CHD; severe HTN; renal or hepatic insufficiency, sepsis; pregnancy, lactation.

Precaution : Avoid frequent & prolonged use, discontinue treatment in impaired peripheral circulation. During prolonged & uninterrupted treatment drug-induced headache & rare case of rectal or anal ulcer occurred.

Drug Interaction : Possible risk of peripheral ischemia w/ erythromycin, troleandomycin, josamycin. Enhanced risk of vasospastic reaction w/ propranolol (rare). Vasoconstrictor agents.

Side Effect : nausea, vomiting; paresthesia, pain & weakness in the extremities; peripheral vasoconstriction (discontinue drug). Precordial pain, myocardial ischaemia & infarction. Prolonged use may cause pleural or retroperitoneal fibrosis or fibrotic changes in the cardiac valves.

Monitoring parameters : Monitor for signs of ergotism such as numbness or tingling of the extremities. BP

Usual Dose : At 1st sign of attack: Adult Initially 2 tab then 1 tab ½ hrly if required. Max: 6 tab/day, 10 tab/wk. Childn 6-12 yr Initially 1 tab. Max: 3 mg/attack/day. Max wkly dose: 5 mg

Missed Dose : Since ergotamine is taken only when needed, you are not likely to miss a dose. Do not take more than 3 ergotamine tablets per day or more than 5 tablets per week.