Dihydroergotamine (Migranal): Dihydroergotamine (DHE) is a medication used primarily for the treatment of migraines. Migranal is one of the brand names for Dihydroergotamine. Here are some details about this medication:

 Dihydroergotamine (DHE) is a medication used primarily for the treatment of migraines. Migranal is one of the brand names for Dihydroergotamine. Here are some details about this medication:

Class and Mechanism of Action:

• Dihydroergotamine belongs to the class of medications known as ergot alkaloids.
• Its mechanism of action is not fully understood, but it is believed to constrict blood vessels in the brain and inhibit the release of certain neurotransmitters, thereby alleviating the symptoms of migraine.

Indications:

• Dihydroergotamine is indicated for the acute treatment of migraine headaches with or without aura.

Dosage:

• The dosage of Dihydroergotamine can vary based on the specific formulation (nasal spray or injection) and the severity of the migraine.
• It is available in nasal spray and injectable forms.
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Administration:

• Migranal nasal spray is typically administered as a single spray into one nostril, with a second spray possible after 15 minutes if needed.
• Injectable forms are administered either intramuscularly (IM) or subcutaneously (SC).

Common Side Effects:

• Nausea
• Vomiting
• Nasal congestion (with nasal spray)
• Local injection site reactions (with injectable forms)
• Dizziness
• Fatigue
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Contraindications:

• Dihydroergotamine is contraindicated in patients with a history of ischemic heart disease, angina, peripheral vascular disease, uncontrolled hypertension, severe liver or kidney disease, or known hypersensitivity to ergot alkaloids.

Drug Interactions:

• Dihydroergotamine may interact with other medications, including strong CYP3A4 inhibitors and certain antifungal medications.
• It should not be used within 24 hours of other ergotamine-containing medications or potent CYP3A4 inhibitors.

Special Considerations:

• Dihydroergotamine should be used with caution in patients with risk factors for cardiovascular disease.
• Prolonged use or excessive dosing of Dihydroergotamine may lead to medication overuse headaches.
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Pregnancy and Lactation:

• Dihydroergotamine is generally not recommended during pregnancy unless the potential benefits outweigh the risks.
• It may be excreted in breast milk, and breastfeeding is not recommended during treatment with Dihydroergotamine.

As with any medication, it is essential for patients to consult with their healthcare provider for personalized advice, especially considering individual health conditions and potential interactions with other medications.