Dihydroergotamine Injection

Some medications should not be taken with dihydroergotamine injection. Using dihydroergotamine injection with some medications may cause serious blood circulation problems. These problems may cause strokes and death. Make sure you have discussed any medications you are currently taking or plan to take before starting dihydroergotamine injection with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking dihydroergotamine, please get the advice of your doctor or pharmacist.

Dihydroergotamine injection is used to treat migraine headaches (severe, throbbing headaches that sometimes are accompanied by nausea and sensitivity to sound and light) and cluster headaches (severe headaches usually on one side of the head or around one eye). Dihydroergotamine is in a class of medications called ergot alkaloids. It works by tightening blood vessels in the brain and by stopping the release of natural substances in the brain that cause swelling.

Dihydroergotamine injection comes as a solution (liquid) in a prefilled autoinjector or an ampule to inject subcutaneously (under the skin). Dihydroergotamine injection also comes as a solution to inject intramuscularly (in a muscle) or intravenously (into a vein) by a doctor or nurse in a medical facility.

If you are injecting dihdyroergotamine subcutaneously, use at the first sign of a migraine headache. If your headache comes back after at least 1 hour, you may inject up to 2 more doses given at least 1 hour apart. Do not use more than three doses in a 24-hour period or 6 doses in a 7-day period. Your doctor will tell you the maximum number of headaches you should treat with dihdyroergotamine injection in a 30-day period.

Use dihydroergotamine injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

If you use dihdyroergotamine injection more often or for longer than the recommended period of time, your headaches may get worse or may occur more often. Call your doctor if your headaches do not get better or occur more frequently after using dihdyroergotamine injection.

You may receive your first dose of dihydroergotamine injection in your doctor's office so that your doctor can monitor your reaction to the medication. After that, you may inject dihydroergotamine at home. Read the written instructions for use that comes with the medication. Ask your doctor or pharmacist if you have any questions about how to inject the medication.

Use each injection only once and inject all the solution in the syringe or autoinjector. Dispose of syringes or autoinjectors in a puncture resistant container. Talk to your doctor or pharmacist about how to dispose of the puncture resistant container.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before using dihydroergotamine injection,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• some medications should not be taken within 24 hours of using dihydroergotamine injection. Tell your doctor if you are taking the following medications: bromocriptine, ergonovine, ergotamine, methylergonovine, and methysergide; or other medications for migraine such as frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan.
• the following nonprescription product may interact with dihydroergotamine: nicotine. Be sure to let your doctor and pharmacist know that you are taking this medication before you start using dihydroergotamine injection. Do not start this medication while using dihydroergotamine injection without discussing with your healthcare provider.
• tell your doctor if you have or have ever had heart disease, a heart attack, angina (chest pain), high blood pressure, peripheral vascular disease (poor circulation in the blood vessels), sepsis (a severe infection of the blood), surgery on your heart or blood vessels, or kidney or liver disease. Your doctor may tell you not to use dihydroergotamine injection.
• tell your doctor if you have a family history of heart disease and if you have or have ever had high cholesterol, diabetes, Raynaud's disease (a condition that affects the fingers and toes), or lung disease.
• tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while using dihydroergotamine injection, call your doctor immediately. Dihydroergotamine can cause preterm labor.
• tell your doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed while you are using dihydroergotamine injection and for 3 days after your last dose.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using dihydroergotamine injection.
• tell your doctor if you use tobacco products. Smoking cigarettes while using this medication increases the risk of serious side effects.

Talk to your doctor about drinking grapefruit juice while using this medicine.

Dihydroergotamine injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away.

• dizziness
• anxiety
• flushing

Some side effects can be serious. If you experience any of the following symptoms, stop using dihydroergotamine injection and call your doctor immediately or get emergency medical treatment:

• color changes, numbness or tingling in fingers and toes
• muscle pain or cramps in arms and legs
• sudden weakness in an arms or leg, drooping of one side of the face, or difficulty speaking or understanding
• pain, tightness, pressure, discomfort, or heaviness in chest, stomach, throat, neck, or jaw; shortness of breath; rapid, pounding, or irregular heartbeat; breaking out in a cold sweat; nausea; vomiting; or lightheadness
• swelling or itching
• sudden or severe stomach pain, constipation, nausea, or vomiting; bloody diarrhea; weight loss; or fever
• shortness of breath, cough, extreme tiredness, unusual weight loss, or muscle or joint pain

Dihydroergotamine may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom). Do not refrigerate or freeze.

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• numbness, tingling, and pain in fingers and toes
• blue color in fingers and toes
• slowed breathing
• confusion
• seizures
• coma
• nausea
• vomiting
• stomach pain

Keep all appointments with your doctor. Your doctor may order certain tests to check your body's response to dihydroergotamine.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

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