This drug may cause dizziness, if affected, do not drive or operate machinery.
Monitor CV status prior to and periodically during therapy.
Symptoms: Nausea, vomiting, numbness, tingling, pain, cyanosis of the extremities, abdominal pain, resp depression, increase and/or decrease in BP, confusion, delirium, convulsions, and coma. Management: Apply warmth to affected area. Provide nursing care to prevent tissue damage. Admin of vasodilators may be beneficial.
Enhanced vasoconstriction w/ other ergot alkaloids, sumatriptan, β-blockers, nicotine, and other vasoconstrictors. May lead to serotonin-like syndrome (e.g. weakness, incoordination, hyperreflexia) when used w/ SSRIs. Potentially Fatal: Concurrent use of potent CYP3A4 inhibitors (e.g protease inhibitors, macrolides, azole antifungals) may cause vasospasm that may lead to cerebral ischaemia.
Description: Dihydroergotamine, an ergot alkaloid, is an α-adrenergic blocker that directly stimulates vascular smooth muscle to constrict peripheral and cerebral vessels. Additionally, it stimulates 5-HT plasma level to counteract the loss of tone of the extracranial vasculature. Onset: 15-30 min (IM). Duration: 3-4 hr (IM). Pharmacokinetics: Absorption: Bioavailability: 43% (nasal). Time to peak plasma concentration: 1-2 min (IV); 24 min (IM); 15-45 min (SC); 30-60 min (nasal). Distribution: Volume of distribution: Approx 800 L. Plasma protein binding: 90-95%. Metabolism: Extensively metabolised to the active metabolite, 8'-β-hydroxydihydroergotamine; and further metabolised via oxidation to the active metabolite, 8',10'-dihydroxydihydroergotamine; undergoes extensive hepatic first-pass metabolism. Excretion: Mainly via faeces; and urine (6-7% as unchanged drug). Elimination half-life: Approx 9-10 hr.
Store below 25°C. Do not refrigerate or freeze. Soln for inj: Protect from light.
Anon. Dihydroergotamine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 22/02/2017.Buckingham R (ed). Dihydroergotamine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/02/2017.Dihydroergotamine Mesylate Injection, Solution (Paddock Laboratories, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 22/02/2017.Dihydroergotamine Mesylate Spray (Oceanside Pharmaceuticals). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 22/02/2017.McEvoy GK, Snow EK, Miller J et al (eds). Dihydroergotamine Mesylate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 22/02/2017.