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Cafetrate Side Effects

Generic Name: caffeine / ergotamine

Note: This document contains side effect information about caffeine / ergotamine. Some of the dosage forms listed on this page may not apply to the brand name Cafetrate.

For the Consumer

Applies to caffeine / ergotamine: oral tablet

Other dosage forms:

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • Chest pain or pressure.
  • Fast or slow heartbeat.
  • A heartbeat that does not feel normal.
  • Swelling.
  • Dizziness or passing out.
  • Muscle pain or weakness.
  • Change in color of hands or feet from pale to blue or red.
  • Numbness, pain, tingling, or cold feeling of the hands or feet.
  • Any sores or wounds on the fingers or toes.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Upset stomach or throwing up.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at

For Healthcare Professionals

Applies to caffeine / ergotamine: oral tablet, rectal suppository


Gastrointestinal side effects including nausea, vomiting, and diarrhea have occurred commonly with ergotamine use.[Ref]


The extremities are most frequently affected by arterial spasm and amputation has occasionally been required.

The headaches during ergotamine withdrawal are often subjectively different in character from the headaches that prompted ergotamine therapy.[Ref]

Other side effects including arterial spasm, sometimes with resulting distal necrosis, have been reported rarely with ergotamine use. Other vascular effects which have been reported rarely include myocardial ischemia or infarction, pulselessness, tongue necrosis, bilateral papillitis, blindness, ischemic pancreatitis, ischemic hepatitis, bowel infarction, renal arteriospasm with acute renal failure, fatal stroke, venous thrombosis, and cerebral arteriopathy.

Withdrawal symptoms, particularly headaches, have been frequently reported after discontinuation of ergotamine, especially after long-term use.

In one study of the effects of caffeine, 634 women with fibrocystic breast disease (compared to 1066 women without the disease), the occurrence of fibrocystic breast disease was positively associated with average daily consumption of caffeine. Women who consumed 31 to 250 mg/day of caffeine were reported to have a 1.5 times increase in odds to have the disease. Women who consumed over 500 mg/day of caffeine were reported to have a 2.3 times increase in odds.

Retroperitoneal fibrosis, pleuropulmonary fibrosis, and pericardial fibrosis have been reported rarely with chronic use of ergotamine and other ergot alkaloids.[Ref]


Cardiovascular side effects including hypertension, tachycardia, bradycardia, precordial distress, chest pain, and valvular disease have been reported with ergotamine use.[Ref]

The valvular lesions induced by ergotamine are echocardiographically similar to those seen in rheumatic heart disease, but are more often found on the mitral and aortic valves. A new murmur heard during ergot therapy should prompt evaluation for ergot-induced valvular disease. Rapid discontinuation of ergot therapy may allow the murmur and valvular lesions to regress.[Ref]


General side effects including caffeinism have been reported. Consumption of higher doses of caffeine (>600 mg/day) has been reported to have lead to caffeinism. Caffeinism is a syndrome characterized by anxiety, restlessness, and sleep disorders (similar to anxiety states). It has also been reported that chronic, heavy caffeine ingestion may be associated with depression. Caffeine may cause anxiety and panic in panic disorder patients and may aggravate PMS.[Ref]


Musculoskeletal side effects including joint pain, muscle cramps, and weakness have been reported with ergotamine use.[Ref]

Nervous system

Nervous system side effects including drowsiness, paresthesias, headache, peripheral neuropathy, vertigo, tremor, dystonia, and reflex sympathetic dystrophy have been reported with ergotamine use.[Ref]


Local side effects including solitary rectal ulcers, anovaginal fistulae, and rectovaginal fistulae have been reported in association with the use of ergotamine suppositories.[Ref]


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

2. Orton DA, Richardson RJ "Ergotamine absorption and toxicity." Postgrad Med J 58 (1982): 6-11

3. Dahlof C "Placebo-controlled clinical trials with ergotamine in the acute treatment of migraine." Cephalalgia 13 (1993): 166-71

4. Bernstein AL "More on ergotamine withdrawal ." Headache 27 (1987): 458

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

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

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

8. Stillman AE, Weinberg M, Mast WC, Palpant S "Ischemic bowel disease attributable to ergot." Gastroenterology 72 (1977): 1336-7

9. 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 232 (1992): 541-4

10. Hokkanen E, Waltimo O, Kallanranta T "Toxic effects of ergotamine used for migraine." Headache 18 (1978): 95-8

11. Mathew NT "Chronic refractory headache." Neurology 43 (1993): s26-33

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

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

14. Fincham RW, Perdue Z, Dunn VD "Bilateral focal cortical atrophy and chronic ergotamine abuse." Neurology 35 (1985): 720-2

15. Gupta DR, Strobos RJ "Bilateral papillitis associated with Cafergot therapy." Neurology 22 (1972): 793-7

16. Lepage-Savary D, Vallieres A "Ergotamine as a possible cause of retroperitoneal fibrosis." Clin Pharm 1 (1982): 179-80

17. Mintz U, Bar-Meir S, De Vries A "Ergotamine-induced venous thrombosis." Postgrad Med J 50 (1974): 244-6

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

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

20. Pusey CD, Rainford DJ "St Anthony's fire and pseudochronic renal failure." Br Med J 2 (1977): 935

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

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

23. Clementz GL, Dailey JW "Psychotropic effects of caffeine." Am Fam Physician 37 (1988): 167-72

24. Sawynok J "Pharmacological rationale for the clinical use of caffeine." Drugs 49 (1995): 37-50

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

Some side effects of Cafetrate may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

More about Cafetrate (caffeine / ergotamine)

Consumer resources

Other brands: Cafergot, Migergot

Professional resources

Related treatment guides

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