Dosing & Uses
Dosage Forms & Strengths
- 2 mg
2 mg SL followed by 1-2 mg q30min until attack abated; not to exceed 6 mg/day and no more than 10 mg/week OR
Menopausal Hot Flashes
0.6 mg PO q12hr (as fixed combo with belladonna and phenobarbital)
Not to exceed 10 mg/week
Commercial oral tablets discontinued in USA; may be compounded
Dosage Forms & Strengths
- 2 mg
1 mg SL, THEN 1 mg q30min PRN, not to exceed 3 mg/episode
Not for very young children
Use not recommended
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Abnormal heart valve findings (chronic use)
Numbness of extremities
Black Box Warnings
Serious and/or life threatening peripheral ischemia has been reported with coadministration of this drug with potent CYP 3A4 inhibitors (including protease inhibitors and macrolide antibiotics). Because CYP3A4 inhibition elevates the serum levels of ergotamine, the risk of vasospasm leading to cerebral ischemia and/or ischemia of the extremities is increased. Concurrent use of these drugs is contraindicated.
Hypersensitivity, PVD, CAD, Raynaud's phenomenon, pregnancy/lactation, sepsis, impaired renal or hepatic function, malnutrition, severe HTN
Concomitant strong CYP3A4 inhibitors
Should be initiated at first sign of vascular headache
Ineffective for muscle contraction headache
Discontinue if S/S of impaired circulation
Possibility of retroperitoneal and pleuropulmonary fibrosis; paresthesia; GI disturbance; chest pain
May exacerbate heart failure
Safety/efficacy not established for peds
Many brands discontinued
Pregnancy & Lactation
Pregnancy Category: X
Lactation: enters breast milk, do not nurse
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Stimulates alpha receptors to vasoconstrict vessels with low vascular tone; vasodilates hypertonic vessels; at higher doses competes for alpha receptor to block it
Half-Life, elimination: 21 hr
Onset: Caffeine may enhance
Peak Plasma Time: 0.5-3 hr
Metabolism: Liver CYP3A4
Excretion: 90% bile
Adding plans allows you to compare formulary status to other drugs in the same class.
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Adding plans allows you to:
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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.