ergotamine

What is the most important information I should know about ergotamine?

This medication can harm an unborn baby or a nursing baby. Do not take ergotamine if you are pregnant or breast-feeding.

Do not take this medication if you are allergic to ergotamine or other ergot medicines, or if you have a history of heart disease, angina (chest pain), blood circulation problems, history of a heart attack or stroke, coronary artery disease, uncontrolled high blood pressure, severe liver or kidney disease, or a serious infection.

Using certain medications together with ergotamine can cause even greater decreases in blood flow than ergotamine used alone, which can lead to dangerous side effects. Tell your doctor about all other medications you are using.

Also tell your doctor about all of your medical conditions, especially high blood pressure, liver or kidney disease, or risk factors for coronary artery disease (diabetes, high blood pressure or cholesterol, menopause or hysterectomy, smoking, taking birth control pills, being overweight, having a family history of coronary artery disease, or being a man older than 40).

This medication will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Never take more than your prescribed dose of ergotamine. An overdose can be fatal.

What is ergotamine?

Ergotamine is in a group of drugs called ergot alkaloids (ER-got AL-ka-loids). It works by narrowing the blood vessels around the brain. Ergotamine also affects blood flow patterns that are associated with certain types of headaches.

Ergotamine is used to treat a migraine type headache.

This medication will only treat a headache that has already begun. It will not prevent migraine headaches or reduce the number of attacks.

Ergotamine should not be used to treat common tension headaches or any headache that seems to be different from your usual migraine headaches.

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

What should I discuss with my healthcare provider before taking ergotamine?

Do not take this medication if you are allergic to ergotamine or similar medications such as Cafergot, D.H.E. 45, Migergot, Migranal, or Methergine.

Do not take ergotamine if you are pregnant or breast-feeding, or if you have:

• a history of heart disease, angina (chest pain), blood circulation problems, or history of a heart attack or stroke;
• coronary artery disease or "hardening of the arteries";
• uncontrolled high blood pressure;
• severe liver disease;
• severe kidney disease; or
• a serious infection called sepsis.

Using certain medications together with ergotamine can cause even greater decreases in blood flow than ergotamine used alone, which can lead to dangerous side effects. Do not take ergotamine if you are also using any of the following medications:

• conivaptan (Vaprisol), imatinib (Gleevec), isoniazid (for treating tuberculosis), or nefazodone (an antidepressant);
• diclofenac (Arthrotec, Cataflam, Voltaren, Flector Patch, Solareze);
• clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), or telithromycin (Ketek);
• clotrimazole (Mycelex Troche), itraconazole (Sporanox), ketoconazole (Extina, Ketozole, Nizoral, Xolegal), or voriconazole (Vfend);
• heart or blood pressure medication such as diltiazem (Cardizem, Dilacor, Tiazac), nicardipine (Cardene), quinidine (Quin-G), or verapamil (Calan, Covera, Isoptin, Verelan); or
• HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase, Fortovase), or ritonavir (Norvir).

Ergotamine can cause rare but serious side effects on the heart, including heart attack or stroke. To make sure you can safely take ergotamine, tell your doctor if you have any of these other conditions:

• high blood pressure;
• liver disease;
• kidney disease; or
• coronary artery disease (or risk factors that include diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

FDA pregnancy category X. Ergotamine can cause birth defects. Do not use if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.

Ergotamine can pass into breast milk and may harm a nursing baby. Ergotamine may also decrease milk production. Do not use if you are breast-feeding a baby.

How should I take ergotamine?

Take exactly as prescribed by your doctor. Never take more than your prescribed dose of ergotamine. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in treating your migraine attacks. Ergotamine is not for daily use.

Take the first dose of ergotamine as soon as you notice headache symptoms, or after an attack has already begun. Place 1 ergotamine tablet under your tongue.

If your headache does not completely go away, you may take a second tablet after at least 30 minutes have passed, and a third tablet if needed after another 30 minutes have passed (a total of 3 tablets).

If you still have migraine symptoms after taking a total of 3 tablets, call your doctor. Do not take more than a total of 3 tablets in any 24-hour period. Do not take more than a total of 5 tablets over a period of 7 days.

Do not give this medication to anyone else, even if they have the same headache symptoms you have. Ergotamine can be dangerous if it is used to treat headache in a person who has not been diagnosed by a doctor as having true migraine headaches.

Store at room temperature away from moisture, heat, and light. Do not take any stored ergotamine if the expiration date on the label has passed.

What happens if I miss a 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.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of ergotamine can be fatal.

Overdose can cause vomiting, confusion, drowsiness, weak pulses in your arms and legs, numbness and tingling or pain in your hands or feet, blue-colored fingers or toes, fainting, and seizure (convulsions).

What should I avoid while taking ergotamine?

Do not take ergotamine within 24 hours before or after using another migraine headache medicine, including:

• dihydroergotamine (D.H.E. 45, Migranal), caffeine and ergotamine (Cafergot, Ercaf, Wigraine), ergonovine (Ergotrate), methylergonovine (Methergine), methysergide (Sansert); or
• almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), sumatriptan (Imitrex), rizatriptan (Maxalt, Maxalt-MLT), or zolmitriptan (Zomig).

Grapefruit and grapefruit juice may interact with ergotamine and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

What are the possible side effects of ergotamine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking ergotamine and call your doctor at once if you have a serious side effect such as:

• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• fast or slow heart rate;
• muscle pain in your arms or legs;
• leg weakness;
• numbness or tingling and a pale or blue-colored appearance in your fingers or toes;
• severe pain in your stomach or lower back;
• urinating less than usual or not at all;
• swelling or itching in any part of your body;
• cough with stabbing chest pain and trouble breathing; or
• dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects may include:

• dizziness, spinning sensation;
• weakness;
• nausea, vomiting; or
• mild itching.

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 ergotamine?

Many drugs can interact with ergotamine. Below is just a partial list. Talk with your doctor before taking ergotamine if you are also taking:

• birth control pills;
• zileuton (Zyflo);
• cold or allergy medications;
• nicotine (Nicoderm, Nicorette);
• diet pills, stimulants, or medication to treat ADHD (such as Ritalin or Adderall);
• an antidepressant such as fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), nefazodone (Serzone), paroxetine (Paxil), sertraline (Zoloft), and others;
• an antibiotic such as metronidazole (Flagyl);
• clotrimazole (Mycelex Troche), fluconazole (Diflucan), or other antifungal medication;
• nitroglycerin or other nitrate medicines such as isosorbide (Isordil, Dilatrate, Imdur, Monoket); or
• heart or blood pressure medication such as atenolol (Tenormin), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others.

This list is not complete and other drugs may interact with ergotamine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about ergotamine.