D.h.e. 45

 
Generic Name: dihydroergotamine

Brands: D.H.E. 45, Migranal

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What is the most important information I should know about D.h.e. 45?

· Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with D.h.e. 45. In rare but severe cases, gangrene or other serious problems can result. Some, but not all, of these medications are listed below in the section "What other drugs will affect D.h.e. 45?". Do not take any other medications during treatment with D.h.e. 45 without first talking to your doctor.

· Notify your doctor immediately if you experience an irregular heartbeat; nausea; vomiting; weakness; or coldness, numbness, or pain in the hands, feet, arms, or legs.

· Do not use more of this medication than is prescribed for you. If your symptoms are not being adequately treated, contact your doctor.

 

What is D.h.e. 45?

· D.h.e. 45 affects vasoconstriction (narrowing of arteries and veins). D.h.e. 45 also affects blood flow patterns that are associated with vascular headaches.

· D.h.e. 45 is used to prevent and to treat vascular headaches such as migraine and cluster headaches.

· D.h.e. 45 may also be used for purposes other than those listed in this medication guide.

 

What should I discuss with my healthcare provider before using D.h.e. 45?

· Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with D.h.e. 45. In rare but severe cases, gangrene or other serious problems can result. Some, but not all, of these medications are listed below in the section "What other drugs will affect D.h.e. 45?". Do not take any other medications during treatment with D.h.e. 45 without first talking to your doctor.

· Do not use D.h.e. 45 without first talking to your doctor if you have     ·peripheral vascular disease or poor circulation;     ·arteriosclerosis or "hardening of the arteries";     ·high blood pressure,     ·heart disease (angina, history of heart attack, silent ischemia);     ·liver disease;     ·kidney disease; or     ·a serious infection.

· You may not be able to use D.h.e. 45, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

· D.h.e. 45 is in the FDA pregnancy category X. This means that it is known to be very harmful if used during pregnancy. D.h.e. 45 can induce uterine contractions, and it can restrict blood flow to the fetus. Do not use D.h.e. 45 if your are pregnant or could become pregnant during treatment.

· D.h.e. 45 passes into breast milk and may be harmful to a nursing infant. D.h.e. 45 may also decrease milk production. Do not use D.h.e. 45 if you are breast-feeding a baby.

 

How should I use D.h.e. 45?

· Use D.h.e. 45 exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

· Use the first dose of D.h.e. 45 at the first sign of a headache.

· For the injectable form of D.h.e. 45, inject up to 1 mg (1 mL) as directed at the first sign of a headache. Two additional doses can be given at 1 hour intervals up to a total of 3 mg (3 mL). Doses smaller than 3 mg may be effective.

· Do not use more than 3 mg in any 24-hour period. Do not use more than 6 mg in any 7 days. If your symptoms are not being adequately treated, see your doctor.

· Store D.h.e. 45 at room temperature away from moisture and heat.

 

What happens if I miss a dose?

· Since D.h.e. 45 is used on an as-needed basis, missing a dose is not usually a problem.

 

What happens if I overdose?

· Seek emergency medical attention.

· Symptoms of a D.h.e. 45 overdose include nausea, vomiting, weakness, muscle pain, numbness in your fingers or toes, gangrene, itching, confusion, drowsiness, convulsions, and possibly death.

 

What should I avoid while taking D.h.e. 45?

· Do not use more of this medication than is prescribed for you. If your symptoms are not being adequately treated, see your doctor.

 

What are the possible side effects of D.h.e. 45?

· Stop taking D.h.e. 45 and seek emergency medical attention or contact your doctor immediately if you experience.     ·an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);     ·chest pain;     ·numbness or tingling in the fingers or toes;     ·muscle pain in the arms or legs;     ·leg weakness;     ·changes in heart rate;     ·swelling; or     ·itching.

· Other, less serious side effects may also occur. Continue to take D.h.e. 45 and talk to your doctor if you experience nausea or vomiting.

· D.h.e. 45 may be habit forming when used for long periods of time. Larger doses may be needed for headache relief, and withdrawal effects may occur when ergotamine therapy is stopped.

· Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

 

What other drugs will affect D.h.e. 45?

· Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with D.h.e. 45. In rare but severe cases, gangrene or other serious problems can result. The following drugs should not be taken with D.h.e. 45 or should be used only under the close supervision of a doctor:     ·another medication that contains an ergot compound such as Ergomar, D.H.E., or D.H.E. Nasal;     ·another migraine headache medicine such as almotriptan (Axert), sumatriptan (Imitrex), zolmitriptan (Zomig), rizatriptan (Maxalt), or naratriptan (Amerge)--these medicines must not be taken within 24 hours of a dose of D.h.e. 45;     ·a selective serotonin reuptake inhibitor (SSRI) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), sertraline (Zoloft), or paroxetine (Paxil);     ·a beta-blocker (which are used to treat high blood pressure, irregular heartbeats, and other heart conditions) such as carteolol (Cartrol), carvedilol (Coreg), labetalol (Normodyne, Trandate), nadolol (Corgard), pindolol (Visken), propranolol (Inderal), sotalol (Betapace), or timolol (Blocadren);     ·an HIV/AIDS medicine such as amprenavir (Agenerase), delavirdine (Rescriptor), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), or saquinavir (Invirase, Fortovase);     ·the antibiotics erythromycin (Ery-Tab, E.E.S., E-Mycin, Eryc, others) or clarithromycin (Biaxin);     ·the antifungals medicines itraconazole (Sporanox) or ketoconazole (Nizoral);     ·nefazodone (Serzone);     ·cimetidine (Tagamet, Tagamet HB); or     ·sibutramine (Meridia).

· Drugs other than those listed here may also interact with D.h.e. 45. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

 

Where can I get more information?

· Your pharmacist has more information about D.h.e. 45 written for health professionals that you may read.

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