Ergotamine Tartrate
Pronouncation: (ehr-GOT-ah-meen TAR-trate)Class: Ergotamine derivatives
Trade Names:
Ergomar
- Tablets, sublingual 2 mg
Pharmacology
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Reduces extracranial blood flow, causes decline in amplitude of pulsation in the cranial arteries and decreases hyperperfusion of the territory of the basilar artery; produces constriction of both arteries and veins.
Pharmacokinetics
Absorption
Poorly absorbed following GI and SL administration.
Metabolism
Metabolized by the liver.
Elimination
T ½ is approximately 2 h; 90% of metabolites are excreted in the bile. Unmetabolized ergotamine is erratically excreted in the saliva and trace amounts are excreted in the feces and urine.
Indications and Usage
Abort or prevent vascular headache (eg, migraine).
Contraindications
Peripheral vascular disease; coronary heart disease; hypertension; hepatic or renal function impairment; severe pruritus; sepsis; hypersensitivity to any component of the product; pregnancy.
Dosage and Administration
SL 2 mg under tongue at first sign of attack or to relieve symptoms after onset of an attack; another tablet should be taken at 30-min intervals thereafter, if necessary (max, 6 mg/24 h and 10 mg in any 1 wk).
General Advice
For SL administration only. Do not crush, chew, or swallow tablet.
Storage/Stability
Store at controlled room temperature (59° to 86°F). Protect from light and heat.
Drug Interactions
TroleandomycinMay elevate ergotamine plasma levels, increasing the pharmacologic effects and adverse reactions.
Laboratory Test Interactions
None well documented.
Adverse Reactions
Cardiovascular
Transient changes in heart rate.
GI
Nausea; vomiting.
Miscellaneous
Weakness of legs, limb muscle pain; numbness and tingling of the fingers and toes; precordial pain; localized edema; itching.
Precautions
MonitorAdverse ReactionsDiscontinue therapy and notify health care provider immediately if any of the following occur: numbness, tingling, coldness, or paleness in the fingers or toes; muscle pain in arms or legs; weakness in the legs; chest pain, tightness or pressure; changes in heart rate; sudden worsening of headache; swelling; itching. |
Pregnancy
Category X .
Lactation
Excreted in breast milk.
Ergotism
Signs and symptoms are rare; however, remain within limits of recommended dosage.
Dependency
Prolonged use may result in dependency and increase the dose requirement for relief of vascular headaches and to prevent dysphoria following withdrawal of the drug.
Overdosage
Symptoms
Nausea, vomiting, weakness of the legs, pain in limb muscles, numbness, itching of fingers and toes, precordial pain, tachycardia, bradycardia, hypertension, hypotension, localized edema, itching together with signs and symptoms of ischemia caused by vasoconstriction of peripheral arteries and arterioles, cold, pale and numb feet and hands, muscle pain while walking and later at rest, gangrene, confusion, depression, drowsiness, convulsions.
Patient Information
- Explain that drug is to be used only during migraine and does not prevent or reduce the number of attacks. Emphasize that drug is used only to treat actual migraine attack.
- Instruct patient in proper use of SL tablet. Caution patient not to chew, crush, or swallow tablet.
- Advise patient that drug is to be taken as soon as symptoms of migraine appear, and that the dose may be repeated every 30 min if needed but that no more than 3 tablets should be used in any 24-h period or 5 tablets used in any 1-wk period.
- Caution patient not to exceed the dosing guidelines because of the risk of toxic effects developing.
- Advise patient to stop taking the drug and notify their health care provider if any of the following occur: numbness, tingling, coldness, or paleness in the fingers or toes; muscle pain in arms or legs; weakness in the legs; chest pain, tightness or pressure; changes in heart rate; sudden worsening of headache; swelling; itching.
- Instruct patient that if they have migraine prophylactic medications prescribed to take daily as directed.
- Advise patient that if not currently taking a migraine prophylactic drug to discuss the use of such drugs with health care provider.
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More Ergotamine Tartrate resources:
Ergomar - Includes detailed dosage instructions.
Ergotamine Tartrate Drug Interactions











