Dihydroergotamine Nasal Spray

Do not take dihydroergotamine if you are taking any of the following medications: antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir); or macrolide antibiotics such as clarithromycin (Biaxin), erythromycin (E.E.S., E-Mycin, Erythrocin), and troleandomycin (TAO).

🔔 Why is this medication prescribed?

Dihydroergotamine is used to treat migraine headaches (severe, throbbing headaches that sometimes are accompanied by nausea and sensitivity to sound and light). Dihydroergotamine is in a class of medications called ergot alkaloids. It works by tightening blood vessels in the brain and by stopping the release of natural substances in the brain that cause swelling.

🔔 How should this medicine be used?

Dihydroergotamine comes as a spray to use in the nose. If you are using dihydroergotamine nasal spray (Migranal) to treat migraine headache, it is given as one spray in each nostril and then after 15 minutes, an additional spray in each nostril for a total of 4 sprays. If you are using dihydroergotamine nasal spray (Trudhesa) to treat migraine headaches, it is given as one spray in each nostril. If headache continues after 1 hour, an additional dose of dihydroergotamine nasal spray (Trudhesa) can be given in each nostril. For all dihydroergotamine nasal spray products, no more than 4 sprays (2 doses) should be given in a 24-hour period or 6 sprays (3 doses) in a 7-day period. Dihydroergotamine nasal spray should be given at start of migraine symptoms but can be used at any time during the migraine. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use dihydroergotamine nasal spray exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

You may use your first dose of dihydroergotamine nasal spray in a doctor’s office or other medical facility where you can be monitored for serious reactions.

Using dihydroergotamine nasal spray more than 10 times in a one month period may cause headaches to worsen. To help prevent this from happening, be sure to mark on a calendar or write down days when dihydroergotamine nasal spray is used.

To use the nasal spray, follow these steps:

1. Read all of the manufacturer’s instructions for using the nasal spray before you use your first dose.
2. Do not assemble sprayer until you are ready to use the product.
3. Remove the blue cap, metal seal and grey rubber stopper from the vial.
4. Remove the plastic cap from the spray pump and attach vial to the bottom of the pump. Rotate clockwise until vial is securely attached to pump.
5. Holding the device upright and pointing away from you, pump the nasal spray 4 times to prime the pump. Do not spray more than 4 times.
6. Once primed, rotate the pump so it is facing you, but keeping it upright, and then insert into first nostril until comfortable and gently press down on pump to release dose into nostril. Then, repeat in the second nostril.
7. For the dihydroergotamine (Migranal) product, refrain from sniffing through the nose during or immediately following use of the nasal spray. For the dihydroergotamine (Trudhesa) product, sniffing during or after nasal spray is not needed but will not hurt you.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

The problem isn’t a shortage of people wanting to be doctors, but rather, too few opportunities for training. Medical schools have increased class sizes by 30% since 2002, but federal funding for residency training – an essential step in the process of becoming a practicing physician – has not increased since 1997, according to Inside Higher Ed.