Dihydroergotamine Side Effects
Medically reviewed by Drugs.com. Last updated on Sep 24, 2023.
Applies to dihydroergotamine: injection solution. Other dosage forms:
Injection route (Solution)
Serious and/or life-threatening peripheral ischemia has been associated with the coadministration of dihydroergotamine with potent CYP3A4 inhibitors including protease inhibitors and macrolide antibiotics. Because CYP3A4 inhibition elevates the serum levels of dihydroergotamine, the risk for vasospasm leading to cerebral ischemia and/or ischemia of the extremities is increased. Hence, concomitant use of these medications is contraindicated.
Serious side effects of Dihydroergotamine
Along with its needed effects, dihydroergotamine 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 dihydroergotamine:
- numbness or tingling in the arms or legs
- trouble thinking, speaking, or walking
Incidence not known
- Chest pain, discomfort, or tightness
- continuing or severe abdominal or stomach pain
- continuing or severe nausea and vomiting
- increased frequency of urination
- lower back or side pain
- pain or discomfort in the arms, jaw, back, or neck
- trouble breathing
Get emergency help immediately if any of the following symptoms of overdose occur while taking dihydroergotamine:
Symptoms of overdose
- Blurred vision
- change or loss of consciousness
- cold clammy skin
- confusion as to time, place, or person
- decreased awareness or responsiveness
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- holding false beliefs that cannot be changed by fact
- numbness, tingling, pain, and bluish color of the fingernails, lips, skin, palms, or nail beds
- pale or blue lips, fingernails, or skin
- pounding in the ears
- severe sleepiness
- slow or fast heartbeat
- stomach pain
- unusual excitement, nervousness, or restlessness
- unusual tiredness or weakness
Other side effects of Dihydroergotamine
Some side effects of dihydroergotamine 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:
- Burning or tingling sensation, dryness, soreness, or pain in the nose
For Healthcare Professionals
Applies to dihydroergotamine: injectable solution, nasal spray.
The most commonly reported adverse events have included nausea and vomiting; with use of the nasal spray, rhinitis, altered sense of taste, and application site reactions have also been reported.
Deaths due to cardiac events have been reported with parenteral use, but no cardiac related deaths were reported during clinical studies with the nasal spray. Reports of serious cardiac events with the injection appear to be rare.[Ref]
Uncommon (0.1% to 1%): Edema, palpitation, tachycardia
Rare (less than 0.1%): Hypotension, peripheral ischemia, angina, cardiac valvular fibrosis
Frequency not reported: Acute myocardial infarction, transient myocardial ischemia, ventricular tachycardia, ventricular fibrillation, coronary artery vasospasm, bradycardia, extrasystoles, intermittent claudication, Raynaud's phenomenon
Postmarketing reports: Vasospasm, hypertension, flushing, peripheral ischemia, gangrene[Ref]
Common (1% to 10%): Dizziness, somnolence, paraesthesia
Uncommon (0.1% to 1%): Tremor, hypoesthesia, altered sense of smell
Rare (less than 0.1%): Speech disorder, hyperkinesia, stupor, abnormal gait, depression, aggravated migraine, convulsions
Very common (10% or more): Local irritation (nasal spray; 30%)
Common (1% to 10%): Application site reactions
Almost 30% of patients receiving the nasal spray reported irritation in the nose, throat, and/or disturbances in taste. Symptoms of congestion, burning, dryness, paraesthesia, discharge, epistaxis, pain, and soreness, mostly mild to moderate and transient, have been reported. In most (approximately 70%), symptoms resolved within 4 hours. The consequence of extended and repeated use on the nasal mucosa have not been studied.[Ref]
Very common (10% or more): Rhinitis (nasal spray; 26%)
Uncommon (0.1% to 1%): Dyspnea, upper respiratory tract infections
Rare (less than 0.1%): Bronchospasm, bronchitis, pleural pain, epistaxis, yawning
Postmarketing reports: Pleural fibrosis[Ref]
The most frequent side effect with the use of intravenous dihydroergotamine is nausea. Following intramuscular or intranasal administration, the incidence of nausea is lower.[Ref]
Common (1% to 10%): Nausea, vomiting, diarrhea
Uncommon (0.1% to 1%): Abdominal pain, dyspepsia, hiccup, dry mouth
Rare (less than 0.1%): Increased salivation, esophagospasm, anorexia
Frequency not reported: Colonic ischemia
Postmarketing reports: Retroperitoneal fibrosis[Ref]
Uncommon (0.1% to 1%): Vertigo, tinnitus, earache, feeling cold, malaise, rigors, fever, fatigue, asthenia[Ref]
Common (1% to 10%): Stiffness
Uncommon (0.1% to 1%): Cramps, myalgia, muscular weakness, dystonia
Rare (Less than 0.1%): Arthralgia, involuntary muscle contractions, rigidity
Frequency not reported: Leg pain, muscle spasms[Ref]
Frequency not reported: Renal artery spasm[Ref]
Frequency not reported: Hypersensitivity reactions such as skin rash, face edema, urticaria, and dyspnea
Uncommon (0.1% to 1%): Photophobia, conjunctivitis, abnormal lacrimation, abnormal vision, periorbital edema
Rare (less than 0.1%): Eye pain
Uncommon (0.1% to 1%): Nervousness, euphoria, insomnia, impaired concentration
Rare (less than 0.1%): Anxiety
Uncommon (0.1% to 1%): Petechia, pruritus, rash, cold clammy skin
Rare (less than 0.1%): Papular rash, urticaria, herpes simplex
Frequency not reported: Sweating
Uncommon (0.1% to 1%): Increased micturition frequency, cystitis
Rare (less than 0.1%): Pelvic inflammation, vaginitis
Frequently asked questions
More about dihydroergotamine
- Check interactions
- Compare alternatives
- Pricing & coupons
- Reviews (45)
- Dosage information
- During pregnancy
- Drug class: antimigraine agents
- Dihydroergotamine injection drug information
- Dihydroergotamine nasal
- Dihydroergotamine (Injection) (Advanced Reading)
- Dihydroergotamine (Nasal) (Advanced Reading)
- Dihydroergotamine Nasal Spray
Related treatment guides
1. Robbins L, Remmes A. Outpatient repetitive intravenous dihydroergotamine. Headache. 1992;32:455-8.
2. Malaquin F, Urban T, Ostinelli J, Ghedira H, Lacronique J. Pleural and retroperitoneal fibrosis from dihydroergotamine . N Engl J Med. 1989;321:1760.
3. Product Information. D.H.E. 45 (dihydroergotamine). Sandoz Pharmaceuticals Corporation. 2002.
4. Backonja M, Beinlich B, Dulli D, Schutta HS. Haloperidol and lorazepam for the treatment of nausea and vomiting associated with the treatment of intractable migraine headaches . Arch Neurol. 1989;46:724.
5. Schulman EA, Rosenberg SB. Claudication: an unusual side effect of DHE administration. Headache. 1991;31:237-9.
6. Drugs for migraine. Med Lett Drugs Ther. 1995;37:17-20.
7. Lipton RB. Ergotamine tartrate and dihydroergotamine mesylate: safety profiles. Headache. 1997;37 Suppl:s33-41.
8. Mattsson E, Ohlin A, Balkfors B, Fredin HO, Nilsson P, Bergqvist D. Lower-limb vasospasm and renal failure during postoperative thromboprophylaxis. Case report. Eur J Surg. 1991;157:289-92.
9. Bachner EJ, Konsens RM, Priem L, King T, Froimson AI. Reversible vasospasm in association with the use of heparin and dihydroergotamine. Clin Orthop. 1992;No. 283:261-4.
10. Henry PY, Larre P, Aupy M, Lafforgue JL, Orgogozo JM. Reversible cerebral arteriopathy associated with the administration of ergot derivatives. Cephalalgia. 1984;4:171-8.
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.