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Caffeine / ergotamine Side Effects

Medically reviewed by Drugs.com. Last updated on Oct 23, 2023.

Applies to caffeine / ergotamine: oral tablet. Other dosage forms:

Serious side effects

Along with its needed effects, caffeine/ergotamine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking caffeine / ergotamine:

Incidence not known

Get emergency help immediately if any of the following symptoms of overdose occur while taking caffeine / ergotamine:

Symptoms of overdose

Other side effects

Some side effects of caffeine / ergotamine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

For Healthcare Professionals

Applies to caffeine / ergotamine: oral tablet, rectal suppository.

General

The most commonly reported adverse effects have included nausea and vomiting.[Ref]

Gastrointestinal

Common (1% to 10%): Nausea, vomiting, abdominal pain

Uncommon (0.1% to 1%): Diarrhea

Frequency not reported: Retroperitoneal fibrosis[Ref]

Nervous system

Reports of cerebral ischemia, including 1 death, have been reported for patients receiving ergotamine and protease inhibitors concomitantly. A black box warning is now required labeling for these drugs.

Drug-induced headaches have been reported during prolonged and uninterrupted use. Withdrawal headaches have been reported with discontinuation after prolonged use.[Ref]

Common (1% to 10%): Dizziness

Uncommon (0.1% to 1%): Paraesthesia, hypoaesthesia

Rare (less than 0.1%): Cerebral ischemia, drowsiness

Frequency not reported: Weakness, somnolence, drug-induced headaches, withdrawal headaches[Ref]

Cardiovascular

Uncommon (0.1% to 1%): Peripheral vasoconstriction

Rare (0.01% to 0.1%): Tachycardia, bradycardia, increased blood pressure

Very rare (less than 0.01%): Myocardial ischemia, myocardial infarction, gangrene

Frequency not reported: Ischemia, cyanosis, absence of pulse, cold extremities, precordial distress, EKG changes[Ref]

Serious vasoconstrictive have occurred, more commonly with long-term therapy at relatively high doses, however, they have been reported with short-term or normal doses.[Ref]

Respiratory

Rare (Less than 0.1%): Dyspnea

Frequency not reported: Pleuropulmonary fibrosis, fibrotic thickening of pulmonary valves

Musculoskeletal

Uncommon (0.1% to 1%): Extremity pain

Rare (Less than 0.1%): Myalgia[Ref]

Hypersensitivity

Rare (less than 0.1%): Rash, face edema, urticaria

Ocular

Frequency not reported: Visual impairment

Postmarketing reports: Loss of vision

Sudden and transient loss of vision have been reported, possibly due to vasospasm and ischemic episode.

Local

Rare (less than 0.1%): Rectal or anal ulcer[Ref]

Solitary rectal or anal ulcer have occurred, usually at higher than recommended doses or with continuous use for many years[Ref]

Other

Frequency not reported: Vertigo[Ref]

Dermatologic

Rare (Less than 0.1%): Rash, face edema, urticaria

References

1. Clementz GL, Dailey JW. Psychotropic effects of caffeine. Am Fam Physician. 1988;37:167-72.

2. Sawynok J. Pharmacological rationale for the clinical use of caffeine. Drugs. 1995;49:37-50.

3. Orton DA, Richardson RJ. Ergotamine absorption and toxicity. Postgrad Med J. 1982;58:6-11.

4. Sanders SW, Haering N, Mosberg H, Jaeger H. Pharmacokinetics of ergotamine in healthy volunteers following oral and rectal dosing. Eur J Clin Pharmacol. 1986;30:331-4.

5. Dahlof C. Placebo-controlled clinical trials with ergotamine in the acute treatment of migraine. Cephalalgia. 1993;13:166-71.

6. Hokkanen E, Waltimo O, Kallanranta T. Toxic effects of ergotamine used for migraine. Headache. 1978;18:95-8.

7. Merello MJ, Nogues MA, Leiguarda RC, Lopez Saubidet C. Dystonia and reflex sympathetic dystrophy induced by ergotamine. Mov Disord. 1991;6:263-4.

8. Redfield MM, Nicholson WJ, Edwards WD, Tajik AJ. Valve disease associated with ergot alkaloid use: echocardiographic and pathologic correlations. Ann Intern Med. 1992;117:50-2.

9. Ibraheem JJ, Paalzow L, Tfelt-Hansen P. Linear pharmacokinetics of intravenous ergotamine tartrate. Eur J Clin Pharmacol. 1985;29:61-6.

10. Benedict CR, Robertson D. Angina pectoris and sudden death in the absence of atherosclerosis following ergotamine therapy for migraine. Am J Med. 1979;67:177-8.

11. Zicot M, Grandfils F, Honore D. Prolonged arterial hemodynamic disturbances in the lower limbs after oral use of ergotamine. Angiology. 1978;29:495-6.

12. Pusey CD, Rainford DJ. St Anthony's fire and pseudochronic renal failure. Br Med J. 1977;2:935.

13. Klein LS, Simpson RJ, Jr Stern R, Hayward JC, Foster JR. Myocardial infarction following administration of sublingual ergotamine. Chest. 1982;82:375-6.

14. Stillman AE, Weinberg M, Mast WC, Palpant S. Ischemic bowel disease attributable to ergot. Gastroenterology. 1977;72:1336-7.

15. Bondeson J, Ericsson UB, Falke P, Mattiasson I, Nyman U, Lindell E, Bernow J. Tongue necrosis in temporal arteritis provoked by ergotamine. J Intern Med. 1992;232:541-4.

16. Gupta DR, Strobos RJ. Bilateral papillitis associated with Cafergot therapy. Neurology. 1972;22:793-7.

17. Fincham RW, Perdue Z, Dunn VD. Bilateral focal cortical atrophy and chronic ergotamine abuse. Neurology. 1985;35:720-2.

18. Mintz U, Bar-Meir S, De Vries A. Ergotamine-induced venous thrombosis. Postgrad Med J. 1974;50:244-6.

19. Lindboe CF, Dahl T, Rostad B. Fatal stroke in migraine: a case report with autopsy findings. Cephalalgia. 1989;9:277-80.

20. Lepage-Savary D, Vallieres A. Ergotamine as a possible cause of retroperitoneal fibrosis. Clin Pharm. 1982;1:179-80.

21. Bernstein AL. More on ergotamine withdrawal . Headache. 1987;27:458.

22. Deviere J, Reuse C, Askenasi R. Ischemic pancreatitis and hepatitis secondary to ergotamine poisoning. J Clin Gastroenterol. 1987;9:350-2.

23. Taal BG, Spierings EL, Hilvering C. Pleuropulmonary fibrosis associated with chronic and excessive intake of ergotamine. Thorax. 1983;38:396-8.

24. Mathew NT. Chronic refractory headache. Neurology. 1993;43:s26-33.

25. Allen MB, Tosh G, Walters G, Muers MF. Pleural and pericardial fibrosis after ergotamine therapy. Respir Med. 1994;88:67-9.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.