Dihydroergotamine review

Dihydroergotamine is an injectable drug administered to treat migraines. Its full name is Dihydroergotamine Mesylate. It is an ergotamine that is hydrogenated in positions 9 and 10 as a mesylate salt. The molecular weight of dihydroergotamine is 679.80. Dihydroergotamine Mesylate is administered as injection. The solution is clear and colorless, and is stored in sterile ampoules which can be administered via intravenous, intramuscular or subcutaneous injection.

Dihydroergotamine Mesylate Injection, USP is intended for use by patients treating migraine pains. Dihydroergotamine is used to treat acute migraine pains, with or without aura. It is also used for the treatment of episodes of cluster headaches.

Dihydroergotamine mesylate solutions are usually colorless and clear. Each mL of the ampule contains 1 mg of Dihydroergotamine Mesylate, USP. Additional components include Alcohol, glycerin, water, sodium hydroxide or methanesulfonic acid.

The dose of 1 ml of dihydroergotamine may be repeated if necessary, at an interval of 1 hour, or a total of 3 mL for intramuscular or subcutaneous administration, or 2 ml for intravenous administration over a 24-hour period. A week’s dosage should not exceed 6 ml.

Some commonly reported side effects upon usage of dihydroergotamine mesylate are dizziness, drowsiness, nausea, headache, diarrhea, flushing, and even increased sweating. Immediately report this to the doctor once you have experienced any of these side effects.

Some unlikely, yet serious side effects may occur like : mood changes, itching, difficulty in breathing, stomach pains, and rashes. More serious side effects may range from chest pain, muscle weakness, erratic heartbeat, problems with vision, confusion, slur in speech and even cardiac arrest.

A few reports have surfaced that the co-administration of dihydroergoatmine and protease inhibitors and antibiotics leads to vasospasm and eventually cerebral ischemia and/or leading to ischemia of the extremities. It is therefore contraindicated with the use of potent CYP 3A4 inhibitors such as ritonavir, erythromycin, ketoconazole, among others.

As dihydroergotamine may increase the patient’s blood pressure, it is not to be administered to patients with a history of hypertension, or to patients with ischemic heart diseases.

Though Dihydroergotamine is used to treat acute migraine, it should not be administered to patients treating hemiplegic or basilar migraine. It is also contraindicated in patients with known peripheral arterial diseases, renal failure. It is also not advised to be administered to pregnant women as possesses oxytocic properties which may cause fetal harm. It should also not be administered to nursing mothers and patients with hypersensitivity to ergot alkaloids.

Dihydroergotamine mesylate injection USP may be self administered by patients. However, prior to self administration, guidance and initial assistance must be sought from the prescribing doctor. If upon administration, numbness or a tingling sensation is felt in the fingers, toes, muscles in the hands or legs, the patient must report to the physician.

The intake of dihydroergotamine mesykate injection USP should be administered in a dose of 1 ml either through IV, IM or subcutaneously. Additional dose may be added if required, but must not exceed 3 within a 24 hour period, or 6 within the week.

Dihydroergotamine has the following structural formula:

Chemical structure of dihydroergotamine

• Molecular formula of dihydroergotamine is C33H37N5O5

Brand name(s): Agit, Angionorm, Dergotamine, Diergo, Dihidroergotamina, Dihydergot, Dihydroergotaminum, Dirgotarl, Endophleban, Ergomimet, Ergont, Ergotonin, Ikaran, Migranal, Morena, Orstanorm, Tonopres, Verladyn

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