Dihydroergotamine Mesylate

Cluster Headache, Migraine Disorders

Treatment

4 Active Studies for Dihydroergotamine Mesylate

What is Dihydroergotamine Mesylate

Dihydroergotamine

The Generic name of this drug

Treatment Summary

Dihydroergotamine is a drug used to treat migraines. It is not as commonly used as other medications due to its less desirable side effects. However, recent advancements in intranasal delivery systems have made it more effective, allowing for a higher concentration of the medication to be delivered to the upper nasal cavity and resulting in a 3-fold increase in effectiveness.

Migranal

is the brand name

image of different drug pills on a surface

Dihydroergotamine Mesylate Overview & Background

Brand Name

Generic Name

First FDA Approval

How many FDA approvals?

Migranal

Dihydroergotamine

1997

21

Effectiveness

How Dihydroergotamine Mesylate Affects Patients

DHE is used to treat migraine headaches and cluster headaches. It works by affecting the nerves and blood vessels in the brain, which can reduce the symptoms associated with the headaches. It does this by stimulating certain serotonin-related activities, which can lead to decreased activity in the trigeminal system, as well as cause constriction of the blood vessels. This can help reduce the pain of a migraine attack and also lead to the side effect of feeling tightness in the chest.

How Dihydroergotamine Mesylate works in the body

DHE works in multiple ways to relieve the effects of migraines. It constricts the blood vessels, which become widened during a migraine attack. It also decreases pain signals sent to the brain, and inhibits the release of chemicals that cause inflammation and pain. DHE has 10 times less potency than ergotamine, meaning it is less likely to cause side effects. However, it is hard to predict how DHE will affect someone due to its slow diffusion from receptors.

When to interrupt dosage

The measure of Dihydroergotamine Mesylate is predicated upon the diagnosed affliction. The amount of dosage is contingent upon the system of delivery (e.g. Intramuscular; Intravenous; Subcutaneous or Spray, metered) delineated in the accompanying 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, Spray, Spray - Nasal, Nasal, Liquid, Liquid - Intramuscular; Intravenous; Subcutaneous, 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, Spray, Spray - Nasal, Nasal, Liquid, Liquid - Intramuscular; Intravenous; Subcutaneous, Liquid - Nasal, Tablet - Oral, Oral, Tablet, Injection, Injection - Intramuscular; Intravenous; Subcutaneous, Spray, metered, Spray, metered - Nasal

Warnings

Dihydroergotamine Mesylate Contraindications

Condition

Risk Level

Notes

Coronary 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

Renal Insufficiency

Do Not Combine

Migraine with Aura

Do Not Combine

Hypertensive disease

Do Not Combine

Liver Failure

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

There are 20 known major drug interactions with Dihydroergotamine Mesylate.

Common Dihydroergotamine Mesylate 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.

Dihydroergotamine Mesylate Toxicity & Overdose Risk

Overdosing on ergot can cause numbness, tingling, pain, and a bluish discoloration of the extremities along with weak or no pulses. Other symptoms may include shallow or absent breathing, changes in blood pressure, confusion, hallucinations, seizures, and vomiting. Those affected should be kept warm and given vasodilators as treatment. Contact local poison control for more information on how to treat ergot overdose.

Dihydroergotamine Mesylate Novel Uses: Which Conditions Have a Clinical Trial Featuring Dihydroergotamine Mesylate?

A total of 7 active studies are exploring the efficacy of Dihydroergotamine Mesylate in treating Cluster Headache.

Condition

Clinical Trials

Trial Phases

Migraine Disorders

1 Actively Recruiting

Not Applicable

Cluster Headache

2 Actively Recruiting

Phase 1, Phase 2

Dihydroergotamine Mesylate Reviews: What are patients saying about Dihydroergotamine Mesylate?

5

Patient Review

6/20/2013

Dihydroergotamine Mesylate for Migraine Headache

Migranal is by far the best of the triptans I've tried. If you start inhaling before you spray it, you can largely avoid nasal congestion.

5

Patient Review

3/1/2012

Dihydroergotamine Mesylate for Migraine Headache

I went to my doctor and my neurologist for a new onset headache. I've always had migraines and have taken other medications before, but this new headache was not like a normal migraine, and persisted for about a month.. Migranal is a lifesaver! after two days (four doses) my month-long headache is gone!

5

Patient Review

1/21/2018

Dihydroergotamine Mesylate for Migraine Headache

I've been using migranal for five years now, and it's completely changed how I manage my migraines. It's by far the most effective medication I've tried-- stronger than anything else I've taken, including IV medications-- with very few side effects.

5

Patient Review

8/7/2013

Dihydroergotamine Mesylate for Migraine Headache

This product is the only one that works for my migraine headaches.

5

Patient Review

7/22/2010

Dihydroergotamine Mesylate for Migraine Headache

5

Patient Review

12/6/2010

Dihydroergotamine Mesylate for Migraine Headache

5

Patient Review

8/8/2011

Dihydroergotamine Mesylate for Migraine Headache

I think the neurologist gave me the wrong medication because I have high blood pressure and am on three different kinds of blood pressure medication.

5

Patient Review

8/17/2011

Dihydroergotamine Mesylate for Migraine Headache

This has been a miracle drug for me. Triptans did not work at all, and acetaminophen gave me rebound headaches. I've been using Migranal for about 3 years and have only had 2 migraines that it couldn't relieve. The taste is awful and it irritates my nose but that is minor compared to the side effects of other migraine meds. Assembling the spray pump is a pain especially when you are in pain. The cost recently skyrocketed but luckily my insurance still covers it.

5

Patient Review

1/19/2016

Dihydroergotamine Mesylate for Migraine Headache

Migranal has been an absolute lifesaver for me! I've tried just about everything over the past 20 years to no avail, but this finally did the trick. The only downside is that it's quite expensive (about $100 per bottle) and insurance companies don't seem too keen on covering it. So I end up hoarding it for only my worst migraines.

4.7

Patient Review

4/8/2022

Dihydroergotamine Mesylate for Migraine Headache

Finally, a medication that works for me! And because it's administered nasally, I don't have to worry about vomiting it up. The only downside is that I often need my husband to administer it because I'm so ill.

4.7

Patient Review

4/29/2013

Dihydroergotamine Mesylate for Migraine Headache

I was not very pleased with this medication. It made me feel like I was in a coma and the pain came back within hours. I researched it and found out that it is commonly given to women during childbirth.

4.7

Patient Review

4/14/2011

Dihydroergotamine Mesylate for Migraine Headache

This medication is excellent at quickly getting rid of migraines. I would highly recommend it to anyone who suffers from migraines on a regular basis.

4.7

Patient Review

7/29/2011

Dihydroergotamine Mesylate for Migraine Headache

This migraine medication is seriously a life saver. If I take it at the first sign of a headache, it's completely gone within an hour.

4

Patient Review

4/25/2021

Dihydroergotamine Mesylate for Migraine Headache

This is the only medication that has been effective in treating my migraines. Unfortunately, I can't take triptans.

3

Patient Review

12/15/2011

Dihydroergotamine Mesylate for Migraine Headache

I've tried so many different migraine medications over the years, and this one is definitely up there as far as effectiveness goes. I was really surprised at how quickly it worked and that I didn't have any of the usual side effects.

2

Patient Review

10/23/2012

Dihydroergotamine Mesylate for Migraine Headache

Unfortunately, this medication made my migraines worse. I've even had to go to the ER for IV treatment as a result. The other issue is that you can't tilt your head back or sniff in when you spray it, so most of it just comes right back out anyway.

2

Patient Review

3/29/2011

Dihydroergotamine Mesylate for Migraine Headache

1.7

Patient Review

7/13/2015

Dihydroergotamine Mesylate for Migraine Headache

Not only did this medication exacerbate my headache, but I woke up with swollen sinuses! Clearly, this isn't an effective solution for migraines.

1.7

Patient Review

3/26/2012

Dihydroergotamine Mesylate for Migraine Headache

I felt like I was in a comatose state :-(
image of drug pills surrounding a glass of water symbolizing drug consumption

Patient Q&A Section about dihydroergotamine mesylate

These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

What is the common name for dihydroergotamine?

"DHE is used to relieve migraines. The active ingredient, dihydroergotamine, is an alkaloid that is derived from ergot. DHE is available in both injectable and nasal spray forms."

Answered by AI

What is dihydroergotamine mesylate used for?

"This medicine is used to only treat acute migraine headaches, with or without aura. It will not relieve pain from any other type of headache. You need a prescription from your doctor to get this medicine."

Answered by AI

Is dihydroergotamine mesylate a narcotic?

"It is used as a non-narcotic analgesic, a vasoconstrictor agent, and a serotonergic agonist. It contains a 9,10alpha-dihydro derivative of ERGOTAMINE."

Answered by AI

How much does dihydroergotamine cost?

"The average cost of Dihydroergotamine Mesylate without insurance is $3,796.69, but the price may vary depending on the dosage prescribed. However, with a SingleCare coupon, the cost of Dihydroergotamine Mesylate is only $905.19 per 1, 1ML of 4MG/ML Solution."

Answered by AI

Clinical Trials for Dihydroergotamine Mesylate

Image of The University of Texas Health Science Center at Houston in Houston, United States.

Capsaicin + Oxygen + Cold Stimuli for Headache

18+
All Sexes
Houston, TX

This study investigates molecular and physical biomarkers of headaches in order to better understand mechanisms of these diseases. There are 3 main parts: 1. Use of capsaicin (active ingredient in hot chili peppers) to trigger release of calcitonin gene related peptide - the hypothesis is that this will be different in headache subjects compared to controls (and if so might be used to predict how these patients will respond to certain medications that modulate calcitonin gene-related peptide). Subjects will be given capsaicin as a cream applied to the forehead or the inner nostril, or a hot sauce that is ingested. 2. Use of capsaicin to trigger eye watering - the hypothesis is that oxygen gas will slow down the amount of eye watering. Cluster headache patients respond very powerfully to oxygen gas but to very little else. The mechanism for oxygen is unknown but in rodents there is data that it works on the parasympathetic / lacrimal gland system. This study translates rodent data into humans in a non-invasive way to confirm the mechanism of this very effective treatment. 3. Use of ice water to trigger headaches - brain freeze causes a very short-lived but intense headache that may cause similar biomarker release as other headache disorders. This may be a useful human model for other headache disorders.

Phase 1
Waitlist Available

The University of Texas Health Science Center at Houston

Mark Burish, MD PhD