Drug
Ergotamine-Caffeine
Pronounced
"er-GOT-uh-meen/KAF-een"
Uses
This combination medication is used to treat or prevent a certain type of headache (vascular headaches such as migraine headaches and cluster headaches). Ergotamine helps narrow widened blood vessels in the head, which reduces the throbbing effects of vascular headaches. Caffeine increases the effects of ergotamine by also narrowing the widened blood vessels in the head.
The suppository form is used when medications cannot be taken by mouth (for example, due to nausea and vomiting).
Warning
This medication has rarely caused a very serious lack of blood flow to the hands and feet (peripheral ischemia) or to the brain, which could cause a stroke. The risk is increased when this medication is taken with other drugs that can affect the removal of ergotamine from your body. Examples include azole antifungals (such as ketoconazole, itraconazole), cobicistat, mifepristone, certain antidepressants (such as nefazodone), macrolide antibiotics (such as clarithromycin, erythromycin, troleandomycin), HIV protease inhibitors (such as ritonavir, nelfinavir, indinavir), SSRIs (such as fluoxetine, paroxetine, fluvoxamine), among others.
How to Use This Medication
Unwrap and insert one suppository rectally as directed by your doctor. Remain lying down for a few minutes, and avoid having a bowel movement for an hour or longer so the drug will be absorbed. The suppository is for rectal use only.
If the suppository is exposed to heat and softens, chill in ice-cold water before unwrapping and using the suppository.
The dosage is based on your medical condition and response to treatment. This medication works best if it is used as the first signs of the headache occur. If you wait until the headache has worsened, the medication may not work as well.
This medication usually should be used only as needed. It is not meant for long-term daily use. The maximum dose is 2 suppositories for a single headache attack and 5 suppositories in any 7-day period.
If you suddenly stop using this medication, you may have withdrawal symptoms (such as rebound headaches). This headache may be different from your original headache and may last a few days. To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used this medication for a long time (more than a few weeks) or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.
If you are using drugs for migraine attacks on 10 or more days each month, the drugs may actually make your headaches worse (medication overuse headache). Do not use medications more often or for longer than directed. Tell your doctor if you need to use this medication more often, or if the medication is not working as well, or if your headaches get worse.