Migranal

Cluster Headache, Migraine Disorders

Treatment

3 Active Studies for Migranal

Treatment for

Cluster Headache

What is Migranal

Dihydroergotamine

The Generic name of this drug

Treatment Summary

Dihydroergotamine is a medication used to treat severe migraines. It is used less often than other medications in its class, such as triptans, because it has more side effects. Recently, a new type of intranasal delivery device has been developed that increases the effectiveness of dihydroergotamine. This device, called Precision Olfactory Delivery technology, has been proven to make the medication three times more effective than other intranasal delivery methods.

Migranal

is the brand name

image of different drug pills on a surface

Migranal Overview & Background

Brand Name

Generic Name

First FDA Approval

How many FDA approvals?

Migranal

Dihydroergotamine

1997

Effectiveness

How Migranal Affects Patients

DHE is a medication used to treat migraine headaches with or without aura, as well as cluster headache episodes. It is thought to work by reducing glutamate levels in the brain, which can help reduce the pain of migraine headaches, and by tightening blood vessels, which can reduce the effects of the chemical (CGRP) that causes blood vessels to widen during a migraine.

How Migranal works in the body

DHE works as an abortive therapy for migraines by acting on several receptor sites in the brain. It causes blood vessels in the head to constrict, reducing inflammation and pain. It also blocks signals sent to the trigeminal nerve, which helps reduce central sensitization. Lastly, it prevents the release of neuropeptides which can cause pain and inflammation. DHE is less potent than its predecessor, ergotamine, which helps reduce side effects. However, it takes some time for DHE to take effect, making it difficult to predict its effects.

When to interrupt dosage

The advised measure of Migranal is contingent upon the diagnosed disorder. The amount of dosage relies on the technique of administration (e.g. Intramuscular; Intravenous; Subcutaneous or Spray, metered) as demonstrated in the table below.

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 - Intramuscular; Intravenous; Subcutaneous, Injection, Spray, metered, Spray, metered - Nasal

Migraine Disorders

, 1.0 mg/mL, 4.0 mg/mL, 2.5 mg, 0.5 mg/pump actuation

Warnings

Migranal 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 Migranal.

Common Migranal 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.

Migranal Toxicity & Overdose Risk

An overdose of ergot can lead to numbness, tingling, and pain in the limbs, accompanied by a decrease or absence of blood flow. Other symptoms include difficulty breathing, changes in blood pressure, confusion, seizures, and nausea. Treatment involves warming the affected areas and providing vasodilators. Contact your local poison control centre for more information about how to handle an ergot overdose.

image of a doctor in a lab doing drug, clinical research

Migranal Novel Uses: Which Conditions Have a Clinical Trial Featuring Migranal?

Presently, seven clinical trials are being conducted to assess the efficacy of Migranal in providing relief for Cluster Headache.

Condition

Clinical Trials

Trial Phases

Migraine Disorders

1 Actively Recruiting

Not Applicable

Cluster Headache

2 Actively Recruiting

Phase 1, Phase 2

Migranal Reviews: What are patients saying about Migranal?

Patient Review

10/1/2022

Migranal for Migraine Headache

This treatment really helped ease my migraines. I'm so grateful that there's finally something that works for me.

Patient Review

8/25/2022

Migranal for Migraine Headache

Nurtec was really effective for me and didn't have any of the side effects that imitrex does. So far, so good!

Patient Review

4/15/2022

Migranal for Migraine Prevention

This medication has been an incredible help for me. Not only does it prevent migraines, but it also lessens their intensity and duration when I do get them. It's really changed my life for the better.

Patient Review

4/15/2022

Migranal for Migraine Prevention

This medication has been fantastic for me. I take it every other day, and it has all but stopped my migraines. When I do get them, they're less severe and don't last as long. It's really improved my quality of life.

Patient Review

8/25/2022

Migranal for Migraine Headache

I got a few samples of this from my doctor to try it out. I normally take imitrex, but it gives me some unpleasant side effects sometimes, so I'm trying different treatments right now. Nurtec worked within an hour for me and had no side effects! So far, so good!

Patient Review

10/1/2022

Migranal for Migraine Headache

This treatment has been a game changer for me. I used to suffer from migraines for years, and this has helped ease them tremendously. Thank you!

4.7

Patient Review

9/11/2022

Migranal for Migraine Headache

Even though this medication is effective for me, I can't afford it because of the high copay.

4.7

Patient Review

9/11/2022

Migranal for Migraine Headache

Even though this treatment is effective for me, I can't justify the high copay.

4.3

Patient Review

4/28/2022

Migranal for Migraine Prevention

I've been using Nurtec for two months to help with migraines. I've tried other medications in the past, but this one seems to be the most effective. The only downside is that some people report joint pain as a side effect, and I'm sensitive to that. So far, though, it's been worth it because I haven't had any luck with triptans.

4.3

Patient Review

4/28/2022

Migranal for Migraine Prevention

I've been using Nurtec for a little over two months now. I tried other medications before this, like CGRPs and vasodilators, but found them to be most effective. However, I have experienced some joint pain while taking this medication.

3.3

Patient Review

4/9/2022

Migranal for Migraine Prevention

While this medication does help to improve my migraines, it takes a few hours to really start working. Additionally, it gives me terrible stomach pain and makes me very drowsy.

3.3

Patient Review

4/9/2022

Migranal for Migraine Prevention

This medication is effective at alleviating migraines, though it does take a few hours to kick in. Unfortunately, it also causes me some intense stomach upset and drowsiness.

Patient Review

4/22/2022

Migranal for Migraine Headache

My migraine was unfortunately not alleviated after two hours, and I experienced other unpleasant side effects like fatigue, shakiness, and brain fog.

Patient Review

4/22/2022

Migranal for Migraine Headache

I was still experiencing the same level of pain and side effects (fatigue, shakiness, brain fog) after two hours.

2.3

Patient Review

9/26/2022

Migranal for Migraine Prevention

I've tried a lot of different medications for my migraines, but this one made me feel much worse. I had awful side effects like diarrhea, nausea, and brain zaps.

2.3

Patient Review

8/6/2022

Migranal for Migraine Headache

I unfortunately couldn't take this as it contains Sucralose, which is known to trigger migraines (as it does for many others). It seems short-sighted to add a migraine trigger to a drug meant for migraine relief. Please provide a non-ODT option in the future.

2.3

Patient Review

9/26/2022

Migranal for Migraine Prevention

I've tried a lot of different medications for my migraines, and this is by far the worst. The side effects are absolutely terrible--I felt nauseous, had indigestion and diarrhea, and couldn't sleep at all. I'm scared to try any other migraine prescriptions now.

2.3

Patient Review

8/6/2022

Migranal for Migraine Headache

I unfortunately could not take this medication as it contains Sucralose, which is a known trigger for migraines (for me and many others). I don't understand why they would add a migraine trigger to a migraine relief drug. Please provide a non-ODT option.

Patient Review

3/26/2022

Migranal for Migraine Prevention

I started taking this medication with high hopes, but by the end of the day I had developed stomach pain and diarrhea. Additionally, I got a headache. This medication is not for me.

Patient Review

11/5/2022

Migranal for Migraine Headache

I tried this medication multiple times, but it didn't help me at all. I had to go back to imitrex.

Patient Review

3/23/2022

Migranal for Migraine Headache

I gave Nurtec a fair chance, but it just didn't work for me. I'm now on my sixth day of migraine and usually they only last four days max. CGRP's seem like one big scam.

Patient Review

3/26/2022

Migranal for Migraine Prevention

I had high hopes for this medication, but it unfortunately didn't work out. I experienced stomach pain and diarrhea, as well as a headache. This just isn't the right treatment for me.

Patient Review

11/5/2022

Migranal for Migraine Headache

I tried this medication several times, but it was ineffective compared to imitrex.

Patient Review

3/23/2022

Migranal for Migraine Headache

I gave this medication a fair chance, but it just didn't work for me. I'm now on my sixth day of a migraine, which is the longest streak I've had in awhile. I'm done with CGRPs; they seem like more trouble than they're worth.

image of drug pills surrounding a glass of water symbolizing drug consumption

Patient Q&A Section about migranal

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

What class of drug is Migranal?

"Migranal is a medication used to treat the symptoms of migraine headaches. It may be used alone or with other medications. Migranal belongs to a class of drugs known as ergot derivatives."

Answered by AI

Is Migranal a triptan?

"Amerge is a type of migraine medication that is classified as a 5HT agonist, while Migranal is classified as an ergot alkaloid."

Answered by AI

How often can I take Migranal?

"Since Migranal is used only when needed, it is unlikely that a dose will be missed. Use no more than 6 sprays of dihydroergotamine nasal per day or more than 8 sprays per week."

Answered by AI