Ergotamine drugs

In this section
Do they work?
What are they?
How can they help?
Why should they work?
Can they be harmful?
What's the evidence?

Do they work?

Drugs based on ergotamine are likely to work. But they are not usually the first choice for treatment because they have serious side effects. They can give you nausea and vomiting, or make your nausea and vomiting worse.

Also, research has found that they work less well for migraine than aspirin and a drug called sumatriptan.

What are they?

Ergotamine is a chemical which makes blood vessels narrower. Drugs based on this chemical are sometimes used to treat migraine attacks. These drugs can be taken alone or in combination with caffeine, which may make ergotamine work a little better.

There are a couple of different ways you can take ergotamine. Your doctor may prescribe it as a tablet or as a suppository (which you insert into your back passage).

If you take ergotamine with caffeine, the brand name is Cafergot. This comes as either a tablet or suppository. If you take it with a drug to help your nausea and vomiting (called cyclizine), the brand name is Migril.

How can they help?

This medicine is likely to help relieve your migraine headaches. It can reduce your pain and may make your headache go away completely.¹

But studies have found that it does not work as well as a triptan drug called sumatriptan.^{2 3} It also doesn't seem to work as well as aspirin.⁴

Why should they work?

When you have a migraine attack, the blood vessels in your brain get wider. Ergotamine drugs cause your blood vessels to narrow. They also stop other processes that researchers think trigger these attacks.

Can they be harmful?

Ergotamine treatments can make some people feel sick and even be sick.¹ Nausea and vomiting is the most common side effect, although this goes away within a quarter of an hour.⁵

Here's what we found out from the research.⁵

• One study found that 1 in 3 people who took ergotamine complained about nausea. But nausea and vomiting went away within 15 minutes.
• Only 1 in 100 people stopped taking ergotamine in the studies.
• Less than 1 in 10 people who had ergotamine injections got side effects. The most common problems were leg cramps and pain where people had the injection. Side effects went away within an hour.

Some serious, but less common side effects of using this medicine also have been reported. They include:

• Problems caused by not having enough blood going to parts of your body
• Fits (seizures)
• Heart problems
• Liver problems
• Leg pain
• Chest pain
• Sudden high blood pressure
• Soreness or redness where an injection of ergotamine is given
• Pain in your head and shoulders
• Numbness.

If you use ergotamine too often, your migraine symptoms may get worse. And it may also affect how much blood gets to your arms and legs. If you take ergotamine for a long time, you can become dependent on it.

Guidelines for doctors recommend avoiding drugs based on ergotamine when possible.⁶ And there are strict limits on how often you should take these medicines. Because of the risks, it is very important that you don't take ergotamine drugs more often than your doctor tells you to.

The narrowing of blood vessels that happens when you take ergotamine can be risky if you have problems with your heart, poor circulation in your legs, high blood pressure, or problems with your kidneys or liver.

Ergotamine products also affect other drugs. You should not take them with triptans, which are another type of medicine used to treat migraine attacks. Ergotamines also interact with:

• Some antibiotics (erythromycin, clarithromycin)
• Beta-blockers such as propranolol
• Some drugs for HIV and AIDS (amprenavir, indinavir, nelfinavir, ritonavir)
• The anti-obesity drug sibutramine
• Antidepressants called selective serotonin reuptake inhibitors (SSRIs)
• Other drugs that make your blood vessels narrower.

What's the evidence?

What's the evidence for ergotamine drugs?