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D.H.E. 45 (injection)

Generic name: dihydroergotamine (injection) [ dye-HYE-droe-er-GOT-a-meen ]
Drug class: Antimigraine agents

Medically reviewed by on Aug 19, 2022. Written by Cerner Multum.

What is D.H.E. 45?

D.H.E. 45 is an ergot alkaloid medicine that is used to treat a migraine or cluster headache attack. D.H.E. 45 will not prevent headaches or reduce the number of attacks.

This medicine is not for common tension headaches or daily use.

D.H.E. 45 may also be used for purposes not listed in this medication guide.


Tell your doctor about all your other medicines. Some drugs should not be used with D.H.E. 45.

Before taking this medicine

You should not use D.H.E. 45 if you are allergic to it or similar medicines (ergotamine, ergonovine, methylergonovine, and others), or if you have:

Some drugs should not be used with D.H.E. 45. Your treatment plan may change if you also use:

Tell your doctor if you have ever had:

  • blood circulation problems in your arms, hands, legs, or feet;

  • chest pain, shortness of breath;

  • liver or kidney disease; or

  • risk factors for coronary artery disease (high blood pressure, high cholesterol, diabetes, menopause, smoking, family history of coronary artery disease, being overweight, being over 40 and a man).

D.H.E. 45 can affect blood circulation to your uterus. Tell your doctor if you are pregnant or plan to become pregnant. Do not use D.H.E. 45 if you are pregnant.

Do not breastfeed while using this medicine, and for at least 3 days after your last dose. Talk with your doctor about the best way to feed your baby.

How should I use D.H.E. 45?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

D.H.E. 45 is injected under the skin or into a muscle. This medicine is sometimes injected into a vein by a healthcare provider.

Use an injection as soon as you notice headache symptoms, or shortly after an attack has begun.

Prepare an injection only when you are ready to give it. Read and follow all Instructions for Use. Ask your doctor or pharmacist if you need help.

If you still have a headache after 1 injection, you may use up to 2 more injections (spaced 1 hour apart), until your headache goes away.

Call your doctor if you still have a headache after 3 injections.

If you have another headache in the same day, you may use the medicine again if at least 6 hours have passed since your last injection.

Do not use more than a total of 3 injections in 24 hours, or more than 6 injections in 1 week.

You may need medical tests to check your heart function.

Store at room temperature away from moisture, heat, and light. Do not use past the expiration date.

Do not reuse a needle or syringe. Place them in a puncture-proof "sharps" container and dispose of it following state or local laws. Keep out of the reach of children and pets.

What happens if I miss a dose?

D.H.E. 45 is used when needed. If you are on a dosing schedule, skip any missed dose. Do not use two doses at one time.

Do not use more than 3 injections per day or 6 injections per week.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal.

What should I avoid while using D.H.E. 45?

Do not use D.H.E. 45 within 24 hours before or after using another migraine headache medicine. This includes another ergot medicine (ergotamine, methylergonovine) or "triptan" medicine (such as almotriptan, eletriptan).

Grapefruit may interact with D.H.E. 45 and cause side effects. Avoid consuming grapefruit products.

D.H.E. 45 side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

D.H.E. 45 may cause serious side effects. Call your doctor at once if you have:

  • signs of a blood clot--sudden numbness or weakness on one side of the body, problems with vision or speech, pain or swelling in one leg;

  • numbness or tingling in your fingers or toes;

  • muscle pain in your arms or legs;

  • leg weakness;

  • fast or slow heartbeats;

  • chest pain or tightness, shortness of breath;

  • swelling or itching;

  • stomach cramps, diarrhea that may be bloody;

  • severe headache; or

  • discoloration or skin changes in your hands or feet.

Common side effects of D.H.E. 45 may include:

  • headache, dizziness, anxiety;

  • diarrhea;

  • numbness, tingling, burning pain;

  • increased blood pressure;

  • rash, increased sweating; or

  • flushing (sudden warmth, redness, or tingly feeling).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect D.H.E. 45?

Tell your doctor about all your current medicines. Many drugs can affect D.H.E. 45, especially:

  • heart or blood pressure medication;

  • nicotine gum or patches;

  • an antidepressant; or

  • medicine to treat an infection.

This list is not complete. Many drugs can affect D.H.E. 45. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you use.

Frequently asked questions

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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