Dihydroergotamine (Into the nose)

Brand Name(s)

Migranal

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to this or any other type of ergot alkaloid. You should not use this medicine if you are pregnant or breastfeeding, or if you have a heart or blood vessel disorder, circulation problems, uncontrolled high blood pressure, or severe liver or kidney disease. You should not use this medicine if you have used sumatriptan (Imitrex®), methysergide (Sansert®), or any other ergot alkaloid within the past 24 hours.

How to Use This Medicine

Spray

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine comes in a kit that contains the ampul (bottle) of medicine and a nasal spray applicator that you will put together when you are ready to use the medicine. After preparing the spray, it should be used within 8 hours.
• The medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
• Never share your medicine with anyone.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose.
• Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

• Store the medicine in a cool place, away from heat and direct light. Do not refrigerate or freeze.
• Use each spray applicator only one time and then throw it away.
• Keep all medicine out of the reach of children.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using epinephrine (Epi-Pen®), antibiotics (such as Biaxin®, erythromycin, troleandomycin, or Zithromax®), blood pressure medicine (such as atenolol, metoprolol, propranolol), medicine for depression (such as trazodone, Celexa®, Effexor®, Paxil®, Prozac®, Serzone®, Zoloft®), or a nasal decongestant (nasal spray or pills you take by mouth).

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Chest pain or tightness, fast or slow heartbeat
• Confusion, lightheadedness or fainting, nausea and vomiting
• Muscle pain or weakness in your arms or legs
• Numbness, tingling, coldness, or bluish coloring in your fingers or toes
• Swelling or itching
• Shallow breathing

If you notice these less serious side effects, talk with your doctor:

• Burning, dryness, numbness, pain, bleeding, or soreness in your nose
• Dizziness
• Nausea
• Runny or stuffy nose

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Introduction

Dihydroergotamine (dye-hye-droe-er-GOT-a-meen)

Treats migraine headaches. This medicine is an ergot alkaloid.

Warnings While Using This Medicine

• Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
• Make sure your doctor knows if you smoke, have had a hysterectomy or have reached menopause, are a man over 40 years of age, or if you have diabetes, high blood pressure or cholesterol, or a family history of coronary artery disease. If you have any of these conditions, your doctor may want to check your heart regularly while you are using this medicine.
• This medicine treats but will not prevent migraine headaches.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.