Migranal Side Effects

Generic name: dihydroergotamine

Medically reviewed by Drugs.com. Last updated on Sep 18, 2024.

Note: This document provides detailed information about Migranal Side Effects associated with dihydroergotamine. Some dosage forms listed on this page may not apply specifically to the brand name Migranal.

Applies to dihydroergotamine: injection solution.

Other dosage forms:

• nasal spray

Precautions

It is very important that your doctor check your progress closely while you are receiving this medicine. This is to see if the medicine is working properly and to allow for a change in the dose. Blood tests may be needed to check for any unwanted effects.

Do not use this medicine together with clarithromycin (Biaxin®), erythromycin (Erythrocin®), indinavir (Crixivan®), itraconazole (Sporanox®), ketoconazole (Nizoral®), nelfinavir (Viracept®), ritonavir (Norvir®), or troleandomycin (Tao®).

This medicine may cause brain problems (eg, cerebral ischemia). Check with your doctor right away if you have confusion, headache, sudden, severe, and continuing, or nausea and vomiting.

If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Signs of an overdose include: blurred vision, change in consciousness, confusion, dizziness, faintness, or lightheadedness when getting up suddenly from a lying position, hallucinations, headache, holding false beliefs that cannot be changed by fact, nervousness, numbness, tingling, pain, and bluish color of the fingernails, lips, skin, palms, or nail beds, irregular, fast or slow, or shallow breathing, loss of consciousness, pale, clammy skin, pounding in the ears, seizures, stomach pain, sweating, trouble breathing, unusual excitement, nervousness, or restlessness, unusual tiredness or weakness, or vomiting.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Using this medicine could harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. Tell your doctor right away if you think you have become pregnant.

This medicine may cause stomach problems (eg, retroperitoneal fibrosis). Check with your doctor right away if you have continuing or severe stomach pain, increased frequency of urination, continuing loss of appetite, lower back pain, continuing or severe nausea and vomiting, or weakness.

Check with your doctor right away if you have chest pain or tightness, or trouble breathing. These may be symptoms of a lung problem (eg, pleural fibrosis).

This medicine may increase your risk of having heart rhythm problems, heart attack, angina, or stroke. This is more likely to occur if you or a family member already has heart disease, if you have diabetes, high blood pressure, or if you smoke. Call your doctor right away if you have any symptoms of a heart problem, such as chest pain or discomfort, an uneven heartbeat, nausea or vomiting, pain or discomfort in the shoulders, arms, jaw, back, or neck, or sweating. Call your doctor right away if you have any symptoms of a stroke, such as confusion, difficulty with speaking, double vision, headaches, an inability to move the arms, legs, or facial muscles, an inability to speak, or slow speech.

Your blood pressure might get too high while you are using this medicine. This may cause headaches, dizziness, or blurred vision. You might need to measure your blood pressure at home. If you think your blood pressure is too high, call your doctor right away.

Using too much of this medicine or any other migraine medicines (eg, triptans, opioids, or a combination treatment for 10 or more days per month) may worsen your headache. Talk to your doctor about this risk. It may also be helpful to note of how often your migraine attacks occur and how much medicines you use.

This medicine may cause some people to become dizzy, drowsy, or less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Common side effects of Migranal

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:

Serious side effects of Migranal

Along with its needed effects, dihydroergotamine (the active ingredient contained in Migranal) 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:

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
• hallucinations
• headache
• holding false beliefs that cannot be changed by fact
• nausea
• nervousness
• 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
• seizures
• severe sleepiness
• slow or fast heartbeat
• stomach pain
• sweating
• unusual excitement, nervousness, or restlessness
• unusual tiredness or weakness
• vomiting

For healthcare professionals

Applies to dihydroergotamine: injectable solution, nasal spray.

General adverse events

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.

Cardiovascular

• 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]

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]

Nervous system

• 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
• Frequency not reported: Cerebral hemorrhage, subarachnoid hemorrhage, stroke, headache^[Ref]

Local

• Very common (10% or more): Local irritation (nasal spray; 30%)
• Common (1% to 10%): Application site reactions
• Uncommon (0.1% to 1%): Local anesthesia^[Ref]

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]

Respiratory

• Very common (10% or more): Rhinitis (nasal spray; 26%)
• Common (1% to 10%): Pharyngitis, sinusitis
• 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]

Gastrointestinal

• 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]

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]

Other

• Uncommon (0.1% to 1%): Vertigo, tinnitus, earache, feeling cold, malaise, rigors, fever, fatigue, asthenia^[Ref]

Musculoskeletal

• 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]

Renal

• Frequency not reported: Renal artery spasm^[Ref]

Hypersensitivity

• Frequency not reported: Hypersensitivity reactions such as skin rash, face edema, urticaria, and dyspnea

Ocular

• Uncommon (0.1% to 1%): Photophobia, conjunctivitis, abnormal lacrimation, abnormal vision, periorbital edema
• Rare (less than 0.1%): Eye pain

Psychiatric

• Uncommon (0.1% to 1%): Nervousness, euphoria, insomnia, impaired concentration
• Rare (less than 0.1%): Anxiety

Dermatologic

• 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

Genitourinary

• Uncommon (0.1% to 1%): Increased micturition frequency, cystitis
• Rare (less than 0.1%): Pelvic inflammation, vaginitis

See also:

Frequently asked questions

• What are the new drugs for the treatment of migraine?

Further information

Migranal side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer