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Overview: Ergotamine is used to treat certain types of headaches, such as migraine or cluster headache. It works by narrowing blood vessels in the brain and blocking certain serotonin receptors, which helps to reduce pain and inflammation. Common side effects may include increased blood pressure, temporary heart rate changes, nausea, vomiting, numbness and tingling, weakness, and feeling off balance. Ergotamine comes as a tablet that dissolves under the tongue.

Uses

What is ergotamine used for?

Ergotamine is commonly used to treat certain types of headache, such as migraine, other types of migraine (such as vestibular migraine or ocular migraine), or cluster headache.

Ergotamine may also be used for other conditions as determined by your health care provider.

How does ergotamine work (mechanism of action)?

Migraine and cluster headaches likely have different causes, but both may involve a widening of blood vessels in the brain, which leads to pain and inflammation. There may also be changes in brain chemicals, such as serotonin. Ergotamine works by narrowing blood vessels in the brain and blocking certain serotonin receptors, which helps to reduce pain and inflammation.

How is ergotamine supplied (dosage forms)?

Brands and other names

  • Ergomar
  • Ergostat
  • Wigrettes

Dosage forms and strengths

  • 2 mg sublingual tablets

How should I store ergotamine?

Ergotamine should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place, and protect from light and heat.

Side Effects

What are the most common side effects of ergotamine?

The most common side effects of ergotamine are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Increased blood pressure (see below)
  • Temporary changes in heart rate
  • Nausea and vomiting
  • Numbness, tingling, or burning in your arms, feet, or face
  • Weakness
  • Feeling off balance

There may be other side effects of ergotamine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of ergotamine?

While less common, the most serious side effects of ergotamine are described below, along with what to do if they happen.

Severe Allergic Reactions. Ergotamine may cause allergic reactions, which can be serious. Stop taking ergotamine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Heart Attack, Other Heart Problems, and Stroke. Ergotamine may increase your risk of heart attack, other heart problems (such as fast or slow heart rate or an abnormal heart rhythm), or stroke, which can lead to death. Stop taking ergotamine and get emergency help if you have any of the following symptoms.

  • Chest pain, pressure, or tightness
  • Fast, slow, or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, neck, jaw, throat, or stomach
  • Unusual sweating
  • Nausea or vomiting
  • Feeling dizzy or lightheaded
  • Weakness or numbness on one side of your body
  • Loss of vision in one or both eyes
  • Sudden, severe headache with no known cause
  • Slurred speech or trouble understanding speech

Blood Flow Problems. Ergotamine may reduce blood flow to many areas of the body, which can be serious. Stop taking ergotamine and tell your health care provider right away if you have any of the following symptoms.

  • Tingling, numbness, or change in color of fingers or toes
  • Muscle pain or weakness
  • Sudden or severe stomach pain
  • Weight loss
  • Constipation or diarrhea
  • Nausea or vomiting

Increased Blood Pressure (Hypertension). Ergotamine may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your health care provider if your blood pressure increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your health care provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Medicine Overuse Headache. Taking too much ergotamine may cause your headaches to happen more often or to get worse. This is called medicine overuse headache or rebound headache. If you notice your headaches happen more frequently than before or are getting worse, contact your health care provider.

Tissue Changes. Ergotamine may rarely cause a buildup of scar tissue and inflammation around the lungs, stomach, or other organs, which is called fibrosis. This can happen in people taking this medicine long-term. Do not take more medicine than prescribed or take it daily long-term. Tell your health care provider if you have any symptoms that concern you.

Warnings & Precautions

Who should not use ergotamine?

Allergies to Ingredients. People who are allergic to any of the following should not take ergotamine.

  • Ergomar
  • Ergostat
  • Ergotamine
  • Wigrettes
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific ergotamine products they stock.

Pregnancy. Do not take ergotamine if you are pregnant or may become pregnant. If you become pregnant, contact your health care provider right away. See the Pregnancy section for more details.

Drug Interactions. Ergotamine should not be taken while you are using certain other medicines because it may increase the risk of severe blood flow problems and possibly stroke or death. Before taking ergotamine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Heart Problems or High Blood Pressure. Ergotamine should not be taken if you have high blood pressure (hypertension) or certain heart problems, such as coronary artery disease. Tell your health care provider if you have these conditions.

Blood Vessel Problems. Ergotamine should not be taken if you have certain problems with your arteries or veins (peripheral vascular disease). Tell your health care provider if you have any problems with your blood vessels.

Kidney Problems. Ergotamine should not be taken if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your health care provider may do tests to see if they are working well enough to take this medicine.

Liver Problems. Ergotamine should not be taken if your liver is not working as well as it should be. If there is a concern about the health of your liver, your health care provider may do tests to see if it is working well enough to take this medicine.

Sepsis. Ergotamine should not be taken if you have sepsis. Sepsis is a life-threatening problem that can happen when your immune system overreacts to an infection and causes organ damage. 

What should I know about ergotamine before using it?

Do not take ergotamine unless it has been prescribed to you by a health care provider. Take it as prescribed. Using ergotamine more often than prescribed may increase the risk of serious side effects. 

Do not share ergotamine with other people, even if they have the same condition as you. It may harm them.

Keep ergotamine out of the reach of children.

Ergotamine works better if taken at the first sign of an attack. Place one tablet under the tongue at the first sign of an attack, or to relieve symptoms after an attack has started. You can take another tablet at 30 minute intervals, if needed, up to a maximum of 3 tablets in 24 hours. Do not take more than 5 tablets in one week. Ergotamine is not for long-term daily use. Ask your health care provider if you have any questions.

It may be helpful to keep a headache journal where you write down when you get your headaches and when you take ergotamine. This information could be shared with your health care provider to see how the medicine is working for you.

What should I tell my health care provider before using ergotamine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if ergotamine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Smoking or Nicotine Use. Nicotine (which can be found in cigarettes, vapes, or products that help you stop smoking) may increase the risk of side effects from ergotamine. Tell your health care provider if you smoke or use any of these products.

Pregnancy. Ergotamine may cause preterm labor and should be avoided during pregnancy. Tell your health care provider right away if you are pregnant or plan to become pregnant.

Breastfeeding. Ergotamine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop ergotamine.

Interactions

Does ergotamine interact with foods or drinks?

Ergotamine may interact with grapefruit or grapefruit juice. Tell your health care provider if you eat grapefruit or drink grapefruit juice before taking ergotamine.

It is unknown if drinking alcohol will affect ergotamine. For some people, alcohol can trigger headaches. Talk to your health care provider if you drink alcohol.

Does ergotamine interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking ergotamine.

  • Clotrimazole, fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend), which is a medicine used for fungal infections
  • Fluoxetine, which is a medicine commonly used for anxiety and depression
  • Fluvoxamine (Luvox), which is a medicine commonly used for obsessive-compulsive disorder (OCD)
  • Nefazodone, which is a medicine used to treat depression
  • A macrolide antibiotic, such as clarithromycin or erythromycin (Ery-Tab and others), which is a medicine used for bacterial infections
  • Metronidazole (Flagyl and others), which is a medicine commonly used to treat bacterial and other infections
  • Zileuton (Zyflo), which is a medicine commonly used for asthma
  • A protease inhibitor, such as atazanavir (Reyataz), nelfinavir (Viracept), or ritonavir (Norvir), which is a medicine commonly used to treat HIV
  • Any other ergot, such as dihydroergotamine (Migranal or Trudhesa), which is a medicine used to treat migraine
  • A beta-blocker, such as atenolol (Tenormin), metoprolol (Lopressor, Toprol XL, and others), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to lower blood pressure
  • A vasoconstrictor, such as pseudoephedrine, which is a medicine that may be used for nasal congestion and can cause blood vessels to narrow

Many other medicines may alter the blood levels of ergotamine. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with ergotamine. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much ergotamine?

If you or someone else has used too much ergotamine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of ergotamine?

Ergotamine is meant to be taken only when needed. Take it as your health care provider recommends. Do not take double or extra doses.