Migranal® Nasal Spray (dihydroergotamine mesylate)
Migranal® (dihydroergotamine mesylate, USP) Nasal Spray, is for the acute treatment of Migraine with or without aura. Ergotamine preparations are non-triptan Migraine abortives. In clinical trials, self-administration of Migranal® Nasal Spray resulted in Migraine pain relief and a reduction in pain intensity as well as a reduction in nausea and sensitivity to both light and sound at 2 and 4 hours. Over 50% of patients in clinical trials did not need additional medications during the 24-hour period following a single 2 mg Migranal® treatment. the nasal spray formulation bypasses the gastrointestinal tract, making it appropriate for patients who suffer from nausea and vomiting as a result of migraine, and who may therefore have difficulty with oral treatments. Migranal® Nasal Spray is a migraine-specific serotonin agonist. It attacks migraine at its source by selectively binding to receptors in the brain that regulate the release of serotonin, a chemical thought to play a major role in the development of migraine. As other dihydroergotamine medications, Migranal® has a strong potential for rebound headaches, aka medication overuse headaches. Thus, it is strongly recommended that it be used no more than two or three days a week. Migranal is also sometimes used to abort cluster headaches.
Developed by Novartis Pharmaceuticals
Corporation, Migranal® was approved as a Migraine abortive by the
U.S. Food and Drug Administration on December 8, 1997.
Type of medication: Rx, abortive, migraine-specific
serotonin
agonist.
Precautions:
- Do not use more than two or three days a week as it can cause medication overuse headache, aka rebound.
- Drinking alcohol can make Migraines worse or trigger additional Migraines. Avoid alcoholic beverages during headache.
- Some people feel drowsy or dizzy
during or after a migraine attack, or after taking Migranal. As long as
you are feeling drowsy or dizzy, do not drive, use machines or do
anything else that could be dangerous.
Pregnancy and Breastfeeding:
- Do not take dihydroergotamine if your are pregnant. Dihydroergotamine can induce uterine contractions, and it can restrict blood flow to the fetus.
- Dihydroergotamine passes into breast milk and can cause vomiting and diarrhea in a nursing infant. Do not take dihydroergotamine if you are breast-feeding a baby.
Other medical
conditions:
Make sure you tell your doctor if you have any
other medical problems, especially those listed below.
- heart or blood vessel disease,
- kidney disease
- liver disease
- hypertension (high blood pressure)
- any infection
Other
medications:
Be sure to tell your doctor if you are taking any other prescription or
over-the-counter medications, especially:
- Imitrex
- Zomig
- Maxalt
- Amerge
- Relpax
- Axert
- Frova
- any other ergot/ergotamine medications
- Cocaine
- Epinephrine by injection. e.g., Epi-Pen
Potential side effects:
Check with your doctor right away if any of the following side effects occur:
- chest pain
- cough, fever, sneezing, or sore throat
- feeling of heaviness in chest
- irregular heartbeat
- itching of the skin
- numbness and tingling of face, fingers, or toes
- pain in arms, legs, or lower back
- pain in back, chest or left arm
- pale bluish-colored or cold hands or feet
- shortness of breath or troubled breathing
- weak or absent pulses in legs
Other side effects may occur that usually do not need medical attention. They may stop as your body adjusts to the medication. However, check with your doctor if any of the following side effects continue or are bothersome:
- Burning or tingling sensation, dryness, soreness, or pain in the nose
- change in sense of taste
- diarrhea
- dizziness
- dry mouth
- fatigue
- headache
- increased sweating
- nausea and or vomiting
- muscle stiffness
- runny and or stuffy nose
- sudden sweating and feelings of warmth
- sensation of burning, warmth, or heat
- sleepiness
- unexplained nose bleeds
- unusual tiredness or weakness, anxiety
- blurred vision
- cold clammy skin
- confusion
- congestion in chest
- cough
- decreased appetite
- depression
- difficulty swallowing
- dizziness or lightheadedness when getting up from a lying or sitting position
- ear pain
- eye pain
- fever
- heartburn
- increased watering of eyes
- increased watering of the mouth
- increased yawning
- muscle weakness
- nervousness
- pinpoint red spots on skin
- pounding heartbeat
- red or irritated eyes
- ringing or buzzing in ears
- skin rash
- stomach pain
- sudden fainting
- swelling of face, fingers, feet, or lower legs
- trembling or shaking of hands or feet
- trouble in sleeping
- unusual feeling of well being
Brand Names:
- U.S.: Migranal
