DIHYDROERGOTAMINE MESYLATE

Dihydroergotamine Mesylate is a semi-synthetic ergot alkaloid used for the acute treatment of migraine and cluster headaches. It works by constricting blood vessels around the brain and reducing the release of inflammatory neuropeptides.

Indications

-Acute treatment of migraine headaches with or without aura -Cluster headaches

Dosage

-Oral: Typically not available in oral form. -Intranasal: 0.5 mg to 1 mg, repeated as needed (maximum 3 mg per day or 4 mg per week). -Intravenous/Intramuscular/Subcutaneous: 1 mg every 8 hours as needed (maximum 3 mg per day or 6 mg per week). -Dosage should be adjusted based on individual patient response and medical condition.

Contra-Indications

-Hypersensitivity to ergot alkaloids -Uncontrolled hypertension -Peripheral vascular disease -Ischemic heart disease -Pregnancy and lactation -Severe renal or hepatic impairment

Special Precautions

-Avoid excessive use, as it may lead to medication-overuse headaches -Not recommended for prolonged use due to the risk of ergotism (vascular constriction leading to ischemia) -Should not be used in combination with potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) due to the risk of severe vasospasm -Use with caution in elderly patients and those with compromised cardiovascular health

Side Effects

-Nausea, vomiting -Dizziness, drowsiness -Flushing, sweating -Muscle pain, weakness -Numbness or tingling in extremities -Chest pain or tightness (seek immediate medical attention)