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Caffeine / ergotamine Side Effects

Medically reviewed by Last updated on Jan 18, 2021.

For the Consumer

Applies to caffeine / ergotamine: oral tablet

Other dosage forms:


  • Poor blood flow to the hands, feet, or brain has happened when this drug was taken with certain other drugs like clarithromycin, erythromycin, indinavir, itraconazole, ketoconazole, nelfinavir, ritonavir, and troleandomycin. This may be very bad or even deadly. Do not take this drug if you are taking any of these drugs. There are many drugs that can do this. Check to make sure that it is safe for you to take this drug with all of your drugs.

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, swallowing, 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.
  • Slow heartbeat.
  • 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.
  • Rarely, heart valve problems have happened with this drug. Call your doctor right away if you have a fast or abnormal heartbeat, shortness of breath, swelling in the arms or legs, or a big weight gain.

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:

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 1-800-332-1088. You may also report side effects at

For Healthcare Professionals

Applies to caffeine / ergotamine: oral tablet, rectal suppository


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


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]


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]


Rare (Less than 0.1%): Dyspnea

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


Uncommon (0.1% to 1%): Extremity pain

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


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


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.


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]


Frequency not reported: Vertigo[Ref]


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


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

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

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

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

5. 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

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

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

8. 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

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

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

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

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

13. 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

14. 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

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

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

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

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

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

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

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

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

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

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

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

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.