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Trudhesa (nasal)

Generic name: dihydroergotamine (nasal) [ dye-HYE-droe-er-GOT-a-meen ]
Brand names: Migranal, Trudhesa
Drug class: Antimigraine agents

Medically reviewed by on Jul 20, 2023. Written by Cerner Multum.

What is dihydroergotamine nasal?

Dihydroergotamine nasal is used to treat migraine headaches with or without aura in adults. Dihydroergotamine nasal will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Dihydroergotamine nasal should not be used to treat any headache that seems to be different from your usual migraine headaches.

Dihydroergotamine nasal may also be used for purposes not listed in this medication guide.

Dihydroergotamine nasal 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.

Trudhesa may cause serious side effects. Call your doctor at once if you have:

Common side effects of Trudhesa may include:

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.


Tell your doctor about all your other medicines. Some drugs should not be used with dihydroergotamine.

Before taking this medicine

You should not use dihydroergotamine if you are allergic to it or similar medicines (ergotamine, ergonovine, methylergonovine, and others), or if you have or have ever had:

Some drugs should not be used with dihydroergotamine. Your treatment plan may change if you also use:

Tell your doctor if you have ever had:

Dihydroergotamine may cause preterm labor. Tell your doctor if you are pregnant or plan to become pregnant. Do not use this medicine if you are pregnant.

Do not breastfeed while using this medicine, and for at least 3 days after your last dose.

How should I use dihydroergotamine nasal?

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

Dihydroergotamine nasal spray is absorbed quickly through your nasal passages and is for use only in the nose. The nasal spray liquid should not be injected into the body.

Your first dose may be given in a medical setting where any serious side effects can be quickly treated.

You should use dihydroergotamine as soon as your headache begins, but it may be given at any time during the migraine episode.

Before your first use, prime the nasal spray device with 4 sprays into the air, away from your face.

Trudhesa: apply one spray in each nostril then another spray in each nostril 1 hour later only if your headache comes back or if you only get some relief from your headache. Use a new nasal spray device for the second dose.

Migranal: apply one spray in each nostril followed by another spray in each nostril 15 minutes later, for a total of 4 sprays.

You may need medical tests to check your heart function.

The nasal spray vial should be thrown away 8 hours after it has been opened.

Store at room temperature away from moisture, heat, and light. Do not keep this medicine in a refrigerator and do not freeze.

What happens if I miss a dose?

Dihydroergotamine nasal is used when needed and does not have a daily dosing schedule.

Do not use more than 2 doses of Trudhesa within 24 hours or 3 doses within 7 days.

Do not use more than 6 sprays of Migranal within 24 hours or 8 sprays within 7 days.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include slow breathing, blood pressure changes, confusion, hallucinations, agitation, convulsions, coma, nausea, vomiting, stomach pain, and pain, numbness, cold feeling, or pale appearance of your fingers or toes.

What should I avoid while using dihydroergotamine nasal?

Do not use dihydroergotamine nasal within 24 hours before or after using another migraine headache medicine, including:

Grapefruit may interact with dihydroergotamine nasal and cause side effects. Avoid consuming grapefruit products.

What other drugs will affect dihydroergotamine nasal?

Tell your doctor about all your current medicines. Many drugs can affect dihydroergotamine, especially:

This list is not complete and many other drugs may affect dihydroergotamine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

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.