Dihydroergotamine nasal spray

What is this medication?

DIHYDROERGOTAMINE (dye hye droe er GOT a meen) is an ergot alkaloid. It is used to treat migraine headaches with or without aura. It should not be used to prevent migraine headaches.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Migranal, TRUDHESA

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• chest pain
• having or recent surgery
• heart attack
• heart disease
• high blood pressure
• infection
• kidney disease
• liver disease
• an unusual or allergic reaction to dihydroergotamine, ergot alkaloids, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medication?

This medicine is for use in the nose. Take it as directed on the prescription label. Do not use it more often than directed. Make sure that you are using your nasal spray correctly. Ask your doctor or health care provider if you have any questions.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your health care provider regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply. This medicine is not for regular use. It should only be used as needed.

What may interact with this medication?

Do not take this medicine with any of the following medications:

• bromocriptine
• ceritinib
• certain antibiotics like erythromycin or clarithromycin
• certain antivirals for HIV or hepatitis
• certain medicines for fungal infections like itraconazole, ketoconazole, posaconazole, or voriconazole
• certain medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
• cocaine
• ergot alkaloids like dihydroergotamine, ergonovine, ergotamine, methylergonovine
• idelalisib
• imatinib
• isoproterenol
• lonafarnib
• mifepristone
• nefazodone
• nitrates
• pseudoephedrine
• ribociclib
• tucatinib

This medicine may also interact with the following medications:

• certain medicines for blood pressure, heart disease, irregular heart beat
• certain medicines for depression, anxiety, or psychotic disorders
• certain medicines for fungal infections like clotrimazole, fluconazole
• nicotine
• zileuton

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your health care provider for regular checks on your progress. Tell your health care provider if your symptoms do not start to get better or if they get worse.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand up or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

Do not become pregnant while taking this medicine. Women should inform their health care provider if they wish to become pregnant or think they might be pregnant. There is potential for serious harm to an unborn child. Talk to your health care provider for more information.

Tell your health care provider right away if you notice unexplained wounds on your fingers or toes while taking this medicine. You should also tell your health care provider if you experience numbness or pain, changes in the skin color, or sensitivity to temperature in your fingers or toes.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care provider as soon as possible:

• allergic reactions (skin rash, itching or hives; swelling of the face, lips, or tongue)
• fast, irregular heartbeat
• heart attack (trouble breathing; pain or tightness in the chest, neck, back or arms; unusually weak or tired)
• increase in blood pressure
• stroke (changes in vision; confusion; trouble speaking or understanding; severe headaches; sudden numbness or weakness of the face, arm or leg; trouble walking; dizziness; loss of balance or coordination)

Side effects that usually do not require medical attention (report to your doctor or health care provider if they continue or are bothersome):

• change in taste
• diarrhea
• dizziness
• nasal congestion (runny or stuffy nose)
• nausea, vomiting
• sore throat
• tiredness

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Do not freeze. Do not refrigerate. Protect from light. Get rid of any unused medicine 8 hours after opening. Get rid of any unused medicine after the expiration date.

To get rid of medicines that are no longer needed or have expired:

• Take the medicine to a medicine take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medicine, check the label or package insert to see if the medicine should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your health care provider. If it is safe to put it in the trash, take the medicine out of the container. Mix the medicine with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.