Vascular headache: Prevention or treatment of vascular headaches, such as migraine, migraine variants.

Antimigraine Agent; Central Nervous System Stimulant; Ergot Derivative

Metabolism: Ergotamine: Extensively hepatic, including high first-pass metabolism.
Bioavailability: Ergotamine: Oral, less than 5%.
Half-life elimination: Ergotamine: 2 to 2.5 hours.
Time to peak, serum: Ergotamine: 2 hours.
Excretion: Ergotamine: Feces (90%, primarily as metabolites).

Hypersensitivity to ergotamine, caffeine, or any component of the formulation; peripheral vascular disease; hepatic or renal impairment; coronary heart disease; hypertension; sepsis; concomitant use of ergot alkaloids with strong inhibitors of CYP3A4 (includes HIV and HCV protease inhibitors, cobicistat, azole antifungals, and some macrolide antibiotics); pregnancy.

X (FDA)

Caffeine is excreted in breast milk and may cause adverse events in a nursing infant. Ergotamine is excreted in breast milk and may cause vomiting, diarrhea, weak pulse, and unstable blood pressure in the nursing infant. Due to the potential for serious adverse reactions in the nursing infant, the manufacturer recommends a decision be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of treatment to the mother.

Serious:
Cardiovascular: Absent pulse, Aortic valve fibrosis, Cold extremities, Cyanosis, Electrocardiogram abnormal, Gangrenous disorder, Ischemia, Precordial pain.
Gastrointestinal: Retroperitoneal fibrosis.
Respiratory: Pulmonary fibrosis.
Other: Ergotism, Withdrawal sign or symptom.

Ergotamine 2 mg and caffeine 200 mg (2 tablets) at onset of attack; then ergotamine 1 mg and caffeine 100 mg (1 tablet) every 30 minutes as needed. Maximum dose: Ergotamine 6 mg and caffeine 600 mg (6 tablets) per attack; do not exceed ergotamine 10 mg and caffeine 1,000 mg (10 tablets) per week.

Use is contraindicated.

Use is contraindicated.