Cafergot is only indicated for the treatment of acute migraine attacks and not for prevention.
Continued daily use of Cafergot or its use in excess of the recommended doses must be avoided since it may cause vasospasm.
Owing to its vasoconstrictor properties, ergotamine may cause myocardial ischaemia or, in rare cases, infarction, even in patients with no known history of coronary heart disease.
Patients who are being treated with Cafergot should be informed of the maximum doses allowed and of the first symptoms of overdosage: hypoaesthesia, paresthesia, (e.g. numbness, tingling) in the fingers and toes, non-migraine-related nausea and vomiting, and symptoms of myocardial ischaemia (e.g. precordial pain). If symptoms such as tingling in the fingers or toes occur, the drug should be discontinued at once and the physician consulted.
If contrary to recommendations ergotamine-containing drugs including Cafergot are used excessively over years, they may induce fibrotic changes, in particular of the pleura and the retroperitoneum. There have also been rare reports of fibrotic changes of the cardiac valves.
Patients with mild to moderate hepatic impairment, especially cholestatic patients should be appropriately monitored.
The occurrence of drug-induced headaches has been reported during prolonged and uninterrupted treatment with Cafergot.
Effects on ability to drive and use machines: Patients experiencing dizziness should not drive or operate machinery.