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Migranal Side Effects

Generic Name: dihydroergotamine

Note: This document contains side effect information about dihydroergotamine. Some of the dosage forms listed on this page 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

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 as soon as possible if any of the following side effects occur while taking dihydroergotamine:

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

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:

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

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

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

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