Pharm

Intranasal Dihydroergotamine

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Intranasal Dihydroergotamine, Migranal

  • Indications
  1. Migraine Abortive Management
  • Efficacy
  1. Significant Migraine response in 30 minutes
    1. Migranal: 70%
    2. Placebo: 28%
  2. Reference
    1. Gallagher (1996) Arch Neurol 53:1285-91 [PubMed]
  • Dosing
  1. Prepare sprayer by inserting ampule and prime pump
  2. Use one spray each nostril
  3. May repeat x1 after 15 minutes (Total dose = 2mg)
  4. Maximum use is 2 times per week
  • Advantages
  1. Lasts longer than intranasal Imitrex
  2. Rebound Headache less common than Imitrex
    1. Rebound HeadacheIncidence: 15% within 24 hours
  3. Less expensive than Intranasal Imitrex ($16/dose)
  • Disadvantages
  1. Does not work as fast as intranasal Imitrex
  2. More complicated to use than intranasal Imitrex
  • Adverse Effects
  1. Rhinitis
  2. Nausea
  3. Taste perversion