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2437 pages added, reviewed or updated during the last month (last updated: 23/4/2021)


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ergotamine in migraine

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The drug ergotamine:

  • is effective in no more than 50% of patients when given sublingually, rectally, or nasally.

  • may require an anti-emetic to be prescribed with it.

  • together with related compounds, should be given by the route that is acceptable to the patient, and doses should be increased to a single effective dose as early as possible in subsequent attacks

  • contraindications:
    • coronary artery disease } has vasoconstrictor
    • peripheral vascular disease } actions and can cause ischaemia
  • possible side effects include:
    • nausea, vomiting, abdominal pain, diarrhoea, muscle cramps, limb paraesthesia, vasoconstriction

  • now largely superseded by the use of 5HT1 agonists e.g. sumatriptan, because of unpredictable efficacy and tolerability in individual patients (1).

Note that ergotamine should not be taken concomitantly with any triptan, but is probably safe after 12 hours (2).

Reference:

  1. Drug and Therapeutics Bulletin 1998; 36(6):41-4.
  2. British Association of the Study of Headache (BASH) guidelines 2004.

Last reviewed 01/2018

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