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What is D.H.E. 45
DihydroergotamineThe Generic name of this drug
Treatment SummaryDihydroergotamine is a medication used to treat migraines. It is not as commonly used as other medications like triptans because it has more side effects. Recent advancements in nasal delivery systems have improved the use of dihydroergotamine, increasing the amount of the drug that reaches the bloodstream. Impel Neuropharma recently developed a new delivery system, Precision Olfactory Delivery, which has been shown to increase the amount of dihydroergotamine in the bloodstream by three times.
Migranalis the brand name
D.H.E. 45 Overview & Background
Brand Name
Generic Name
First FDA Approval
How many FDA approvals?
Migranal
Dihydroergotamine
1997
21
Effectiveness
How D.H.E. 45 Affects PatientsDHE is used to treat migraine headaches with or without an aura, as well as cluster headache episodes. It works by activating serotonin, which can reduce the amount of glutamate in the brain and help prevent migraine headaches. It also causes blood vessels to narrow, which can help reduce migraine pain and cause the side effect of chest tightness.
How D.H.E. 45 works in the bodyDHE is believed to treat migraines in multiple ways. One way is by constricting the blood vessels that become widened during a migraine. It also blocks pain signals between the thalamus and trigeminal nerve in the brain, and reduces inflammation and pain in the trigeminal nerve. DHE has 10 times less potency than ergotamine so it is less likely to cause vascular side effects. It is difficult to predict how long its effects will last because it takes time for it to diffuse from receptors in the body.
When to interrupt dosage
The dose of D.H.E. 45 is contingent upon the diagnosed affliction. The amount of dosage likewise differs as per the delivery technique (e.g. Intramuscular; Intravenous; Subcutaneous or Spray, metered) featured in the ensuing table.Condition
Dosage
Administration
Cluster Headache
, 1.0 mg/mL, 4.0 mg/mL, 2.5 mg, 0.5 mg/pump actuation
, Intramuscular; Intravenous; Subcutaneous, Injection, solution, Injection, solution - Intramuscular; Intravenous; Subcutaneous, Nasal, Spray, Spray - Nasal, Liquid - Intramuscular; Intravenous; Subcutaneous, Liquid, Liquid - Nasal, Tablet - Oral, Oral, Tablet, Injection, Injection - Intramuscular; Intravenous; Subcutaneous, Spray, metered, Spray, metered - Nasal
Migraine Disorders
, 1.0 mg/mL, 4.0 mg/mL, 2.5 mg, 0.5 mg/pump actuation
, Intramuscular; Intravenous; Subcutaneous, Injection, solution, Injection, solution - Intramuscular; Intravenous; Subcutaneous, Nasal, Spray, Spray - Nasal, Liquid - Intramuscular; Intravenous; Subcutaneous, Liquid, Liquid - Nasal, Tablet - Oral, Oral, Tablet, Injection, Injection - Intramuscular; Intravenous; Subcutaneous, Spray, metered, Spray, metered - Nasal
Warnings
D.H.E. 45 has nineteen contraindications, and should thus be abstained from if any of the conditions in the ensuing table are encountered.D.H.E. 45 ContraindicationsCondition
Risk Level
Notes
Coronary Artery Vasospasm
Do Not Combine
Pulse Frequency
Do Not Combine
Pulse Frequency
Do Not Combine
Chest Pain
Do Not Combine
Pulse Frequency
Do Not Combine
Documented Silent Ischemia
Do Not Combine
Severe Hepatic Impairment
Do Not Combine
severe renal dysfunction
Do Not Combine
Basilar Migraine
Do Not Combine
Hypertensive disease
Do Not Combine
severe hepatic dysfunction
Do Not Combine
Hemiplegic migraine
Do Not Combine
Vasospastic Angina
Do Not Combine
Women who are breast-feeding or pregnant
Do Not Combine
Vascular Surgery
Do Not Combine
Peripheral Arterial Disease
Do Not Combine
Pulse Frequency
Do Not Combine
Coronary Artery Disease
Do Not Combine
Severe Hypersensitivity Reactions
Do Not Combine
Dihydroergotamine may interact with Pulse Frequency
Common D.H.E. 45 Drug Interactions
Drug Name
Risk Level
Description
4-Bromo-2,5-dimethoxyphenethylamine
Major
Dihydroergotamine may increase the hypertensive and vasoconstricting activities of 4-Bromo-2,5-dimethoxyphenethylamine.
4-Methoxyamphetamine
Major
Dihydroergotamine may increase the hypertensive and vasoconstricting activities of 4-Methoxyamphetamine.
5-methoxy-N,N-dimethyltryptamine
Major
Dihydroergotamine may increase the vasoconstricting activities of 5-methoxy-N,N-dimethyltryptamine.
Abediterol
Major
Dihydroergotamine may increase the hypertensive and vasoconstricting activities of Abediterol.
Abemaciclib
Major
The metabolism of Abemaciclib can be decreased when combined with Dihydroergotamine.
D.H.E. 45 Toxicity & Overdose RiskOverdosing on ergot may lead to numbness, tingling, and pain in the extremities, difficulty breathing, fluctuations in blood pressure, mental confusion, seizures, coma, nausea, vomiting, and abdominal pain. In case of overdose, affected areas should be warmed and vasodilators administered. Contact local poison control centres for more detailed instructions on how to treat ergot overdose.
D.H.E. 45 Novel Uses: Which Conditions Have a Clinical Trial Featuring D.H.E. 45?
A total of 7 active studies are investigating the potential of D.H.E. 45 to alleviate symptoms of Cluster Headache.Condition
Clinical Trials
Trial Phases
Migraine Disorders
0 Actively Recruiting
Cluster Headache
4 Actively Recruiting
Phase 1, Phase 3, Phase 2
D.H.E. 45 Reviews: What are patients saying about D.H.E. 45?
5Patient Review
5/26/2010 I was given this drug intravenously in the ER and it was a really terrible experience. I started to feel antsy, then sort of nervous, and then the worst thing happened: I felt like I was going to jump out of my skin. It's hard to describe but I felt like I had been given a massive dose of caffeine.
5Patient Review
11/25/20085Patient Review
1/10/20094.7Patient Review
9/18/2010 I found this medication to be totally ineffective. I have been suffering from migraines for over 13 years, and was horrified when the doctor prescribed this old drug that has severe side effects. Even the pharmacy took two hours to get it in the hospital! If you're in pain, you need something that will actually help.
4Patient Review
10/10/2011 I've been struggling with migraines for over 17 years now, and my neurologist suggested a 3-day infusion treatment. DHE was the only drug that worked for me out of everything we tried. I would highly recommend it to anyone else facing similar issues.
4Patient Review
7/3/2010 DHE is the only treatment that works for me and it's amazing!
1.7Patient Review
3/7/2011 I was hospitalized for four days with a debilitating migane that didn't respond to any traditional treatments. This medication finally got my pain down to a more manageable level. The only side effect I experienced was some diarrhea, which is a fair tradeoff in my opinion.
1Patient Review
1/26/2015 This medication is given every 8 hours, usually in a hospital setting, for 2 to 5 days. Most people will experience gastrointestinal upset from the medication, so Reglan (metoclapromide) is also administered. However, some people have reported feeling agitated and restless after taking Reglan. I found that this regimen helped reduce the intensity of my chronic migraines.
Patient Q&A Section about d.h.e. 45
These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.How does DHE make you feel?
"The following are side effects that may occur when taking the medication: dizziness, drowsiness, headache, nausea, vomiting, diarrhea, flushing, increased sweating, anxiety, or skin rash."
Answered by AI
What is a DHE injection?
"D.H.E. 45 should only be used to treat an active migraine headache. Do not use it to prevent a headache if you have no symptoms and do not use it to treat a tension headache that is not typical of your usual migraine headache."
Answered by AI
How long does DHE infusion last?
"The original protocol for treating migraines called for administering a dose of 0.3-1 mg of DHE every 8 hours, along with 10 mg of metoclopramide for 2-3 days."
Answered by AI
How does DHE work for migraines?
"Dihydroergotamine is a medication that attaches to pain receptors in the brain and nerves, changing how messages are sent back and forth. This changes the perception of pain in the brain. DHE does not 'cure' headaches but it should improve how often they occur and how severe they are."
Answered by AI