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Migranal Side Effects

Generic Name: dihydroergotamine

Note: This page contains information about the side effects of dihydroergotamine. Some of the dosage forms included on this document may not apply to the brand name Migranal.

In Summary

Common side effects of Migranal include: nausea and rhinitis. Other side effects include: application site reaction, vomiting, and altered sense of smell. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to dihydroergotamine: nasal spray

In addition to its needed effects, some unwanted effects may be caused by dihydroergotamine (the active ingredient contained in Migranal). In the event that any of these side effects do occur, they may require medical attention.

Severity: Moderate

If any of the following side effects occur while taking dihydroergotamine, check with your doctor or nurse as soon as possible:

Less common or rare:
  • Chest pain
  • cough, fever, sneezing, or sore throat
  • feeling of heaviness in chest
  • irregular heartbeat
  • itching of the skin
  • numbness and tingling of face, fingers, or toes
  • pain in arms, legs, or lower back
  • pain in back, chest or left arm
  • pale bluish-colored or cold hands or feet
  • shortness of breath or troubled breathing
  • weak or absent pulses in legs
Symptoms of overdose:
  • Confusion
  • convulsions (seizures)
  • delirium
  • dizziness
  • headaches
  • nausea and/or vomiting
  • numbness, tingling, and/or pain in the legs or arms
  • shortness of breath
  • stomach pain

Minor Side Effects

Some of the side effects that can occur with dihydroergotamine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Burning or tingling sensation, dryness, soreness, or pain in the nose
  • change in sense of taste
  • diarrhea
  • dizziness
  • dry mouth
  • fatigue
  • headache
  • increased sweating
  • nausea and or vomiting
  • muscle stiffness
  • runny and or stuffy nose
  • sudden sweatings and feelings of warmth
  • sensation of burning, warmth, or heat
  • sore throat
  • sleepiness
  • unexplained nose bleeds
  • unusual tiredness or weakness
Less common:
  • Anxiety
  • blurred vision
  • cold clammy skin
  • confusion
  • congestion in chest
  • cough
  • decreased appetite
  • depression
  • difficulty swallowing
  • dizziness or lightheadedness when getting up from a lying or sitting position
  • ear pain
  • eye pain
  • fever
  • heartburn
  • increased watering of eyes
  • increased watering of the mouth
  • increased yawning
  • muscle weakness
  • nervousness
  • pinpoint red spots on skin
  • pounding heartbeat
  • red or irritated eyes
  • ringing or buzzing in ears
  • skin rash
  • stomach pain
  • sudden fainting
  • swelling of face, fingers, feet, or lower legs
  • trembling or shaking of hands or feet
  • trouble in sleeping
  • unusual feeling of well being

For Healthcare Professionals

Applies to dihydroergotamine: injectable solution, nasal spray


Gastrointestinal side effects including nausea, vomiting, and diarrhea have been reported to occur commonly.[Ref]

The most frequent side effect with the use of intravenous dihydroergotamine is nausea. Following intramuscular or intranasal administration, the incidence of nausea is low.[Ref]


Other side effects including arterial spasm, sometimes with resulting limb necrosis, have been reported rarely. The incidence is believed to be about 1 to 3 per 100,000 patients treated for thromboprophylaxis.[Ref]


Musculoskeletal side effects including muscle cramps and weakness have been reported.[Ref]

Nervous system

Nervous system side effects including drowsiness, restlessness, cerebral arteriopathy, and paresthesias have been reported.[Ref]


Local side effects including pain, burning, itching, edemas, and hematomas at the site of parenteral administration have been reported to occur commonly.[Ref]


Cardiovascular side effects including hypertension, tachycardia, bradycardia, precordial distress, and chest pain have been reported. Myocardial ischemia and myocardial infarction have been reported rarely.[Ref]


Respiratory side effects including pleural fibrosis have been reported following long-term high dose treatment.[Ref]


Renal side effect including retroperitoneal fibrosis have been reported following long-term high dose treatment.[Ref]


1. Schulman EA, Rosenberg SB "Claudication: an unusual side effect of DHE administration." Headache 31 (1991): 237-9

2. "Drugs for migraine." Med Lett Drugs Ther 37 (1995): 17-20

3. Lipton RB "Ergotamine tartrate and dihydroergotamine mesylate: safety profiles." Headache 37 Suppl (1997): s33-41

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 46 (1989): 724

5. Robbins L, Remmes A "Outpatient repetitive intravenous dihydroergotamine." Headache 32 (1992): 455-8

6. Henry PY, Larre P, Aupy M, Lafforgue JL, Orgogozo JM "Reversible cerebral arteriopathy associated with the administration of ergot derivatives." Cephalalgia 4 (1984): 171-8

7. Bachner EJ, Konsens RM, Priem L, King T, Froimson AI "Reversible vasospasm in association with the use of heparin and dihydroergotamine." Clin Orthop No. 283 (1992): 261-4

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 157 (1991): 289-92

9. "Product Information. D.H.E. 45 (dihydroergotamine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.

10. Malaquin F, Urban T, Ostinelli J, Ghedira H, Lacronique J "Pleural and retroperitoneal fibrosis from dihydroergotamine ." N Engl J Med 321 (1989): 1760

Not all side effects for Migranal may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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