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ergotamine (Rx)Brand and Other Names:Ergomar

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet, SL

  • 2 mg
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Migraine

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

tablet, SL

  • 2 mg
more...

Migraine (Off-label)

1 mg SL, THEN 1 mg q30min PRN, not to exceed 3 mg/episode

Not for very young children

Use not recommended

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Interactions

Interaction Checker

ergotamine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Abnormal heart valve findings (chronic use)

            Angina

            Arrhythmia

            Vascular spasm

            Vasoconstriction

            Tachycardia

            Fatigue

            Numbness of extremities

            Rebound headache

            Abdominal pain

            Ergotism

            Possible gangrene

            Paresthesia

            Pruritis

            Nausea

            Vomiting

            Muscle weakness

            Visual disturbances

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            Warnings

            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.

            Contraindications

            Hypersensitivity, PVD, CAD, Raynaud's phenomenon, pregnancy/lactation, sepsis, impaired renal or hepatic function, malnutrition, severe HTN

            Concomitant strong CYP3A4 inhibitors

            Cautions

            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

            Safety/efficacy not established for peds

            Many brands discontinued

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            Pregnancy & Lactation

            Pregnancy Category: X

            Lactation: enters breast milk, do not nurse

            Pregnancy Categories

            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.

            more...
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            Pharmacology

            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

            Pharmacokinetics

            Half-Life, elimination: 21 hr

            Onset: Caffeine may enhance

            Peak Plasma Time: 0.5-3 hr

            Metabolism: Liver CYP3A4

            Excretion: 90% bile

            Dialyzable: Yes

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            Images

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            Formulary

            FormularyPatient Discounts

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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.

            Tier Description
            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.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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