Which medications in the drug class Ergot Derivatives are used in the treatment of Cluster Headache?

Updated: Jun 07, 2019
  • Author: Michelle Blanda, MD; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Answer

Ergot Derivatives

Ergot alkaloids are highly effective in relieving acute CH pain. They are direct vasoconstrictors of smooth muscle in cranial blood vessels, and their activity depends on central nervous system (CNS) vascular tone at the time of administration.

Dihydroergotamine (D.H.E. 45 injection, Migranal)

Dihydroergotamine has alpha-adrenergic antagonist and serotonin antagonist effects. It is available in IV or intranasal preparations and tends to cause less arterial vasoconstriction than ergotamine tartrate.

Ergotamine (Ergomar)

Ergotamine has alpha-adrenergic antagonist and serotonin antagonist effects and causes constriction of peripheral and cranial blood vessels. Oral administration of ergotamine is not as effective as inhaled, rectal, or sublingual administration for treatment of acute cluster attacks. To prevent rebound headaches, avoid exceeding maximum dosage guidelines.


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