Dihydroergotamine

This information from Lexicomp^® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

D.H.E. 45 [DSC]; Migranal; Trudhesa

Brand Names: Canada

DHE; Migranal

What is this drug used for?

• It is used to treat migraine headaches.
• Some products are used to treat cluster headaches.
• It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have any of these health problems: High blood pressure or some types of migraine headaches like hemiplegic or basilar migraine.
• If you have any of these health problems: Blood vessel problems, chest pain or pressure, heart disease, kidney disease, liver disease, poor blood flow, very bad infection, or recent blood vessel surgery.
• If you have ever had a heart attack.
• If you have taken almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, or zolmitriptan in the last 24 hours.
• If you have taken ergotamine, methysergide, or any drug like them in the last 24 hours.
• If you are pregnant or may be pregnant. Do not take this drug if you are pregnant.
• If you are breast-feeding. Do not breast-feed while you take this drug and for 3 days after your last dose.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
• If you drink grapefruit juice or eat grapefruit often, talk with your doctor.
• This drug is not meant for regular, daily use. Talk with the doctor.
• This drug is not meant to prevent or lower the number of migraine headaches you get.
• Do not use more than what your doctor told you to use. Do not use more often or longer than what you were told. Doing any of these things may raise the chance of very bad side effects.
• High blood pressure has happened with this drug. Have your blood pressure checked as you have been told by your doctor.
• Use care if you have risks for heart disease (high blood pressure, high cholesterol, overweight, high blood sugar or diabetes, cigarette smoking, male older than 40 years of age, other family members with early heart disease, female after menopause). Talk with your doctor.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
• Change in color of hands, feet, or other areas. Skin may turn pale, blue, gray, purple, or red.
• Numbness, pain, tingling, or cold feeling of the hands or feet.
• Any sores or wounds on the fingers or toes.
• Muscle pain or weakness.
• Cramping or pain in the legs or hips.
• Feeling of heaviness or tightness in the leg muscles.
• Burning or aching pain in the feet or toes.
• Swelling.
• Diarrhea or constipation.
• Severe stomach pain or bloody diarrhea.
• Belly pain after meals.
• Fever.
• Weight loss.
• Severe and sometimes deadly heart problems like heart attack and an abnormal heartbeat have happened with this drug. Call your doctor right away if you have chest, throat, neck, or jaw tightness, pain, pressure, or heaviness; abnormal arm, back, neck, jaw, or stomach pain; shortness of breath; cold sweats; severe upset stomach or throwing up; or feeling dizzy or passing out.
• Very bad and sometimes deadly brain blood vessel problems like stroke have rarely happened with this drug. Call your doctor right away if you have weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on 1 side of the face, or change in eyesight.
• Rarely, heart valve problems have happened with this drug. Call your doctor right away if you have a fast or abnormal heartbeat, shortness of breath, swelling in the arms or legs, or a big weight gain.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

All products:

• Upset stomach or throwing up.

Nose spray:

• Nose or throat irritation.
• Change in taste.
• Nosebleed.
• Runny or stuffy nose.
• Burning.
• Dry nose.
• Feeling sleepy.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

Injection:

• It is given as a shot into a muscle or into the fatty part of the skin.
• If you will be giving yourself the shot, your doctor or nurse will teach you how to give the shot.
• Do not use if the solution is cloudy, leaking, or has particles.
• Do not use if solution changes color.
• Wash your hands before and after use.
• After opening the ampule, throw away any part not used after 1 hour.
• Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for getting rid of it. Talk with a doctor or pharmacist if you have any questions.

Nose spray:

• For the nose only.
• Use this drug as early as you can after the attack has started.
• This product needs to be put together before using. Once the vial is opened and the nose spray is put together, use within 8 hours. If not used within 8 hours, throw the prepared spray away.
• Before first use, prime the pump by spraying 4 times. After priming, be sure you know how long the product is good for. Ask your doctor or pharmacist if you are not sure.
• Breathe in 1 spray in each nostril. Some products are to be used again as 1 more spray in each nostril 15 minutes later. Some products are to be used as 1 more spray in each nostril 1 hour later only if your headache comes back or if you only get some relief. Only do this if your doctor has told you to do so. Be sure you know how to use this drug. Talk with your doctor if you have questions.
• Do not tilt your head back or sniff through the nose while spraying this drug or right after use.

What do I do if I miss a dose?

• This drug is taken on an as needed basis. Do not take more often than told by the doctor.

How do I store and/or throw out this drug?

Nose spray:

• Store at room temperature. Do not refrigerate or freeze.
• Protect from heat and light.

Injection:

• Most of the time, this drug will be given in a hospital or doctor’s office. If stored at home, follow how to store as you were told by the doctor.

All products:

• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else’s drugs.
• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-08-05

Copyright

© 2024 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.