What is caffeine and ergotamine?
Caffeine and ergotamine both cause vasoconstriction (narrowing) of arteries and veins that supply blood to the head.
Caffeine and ergotamine is used to prevent and to treat vascular headaches such as migraine and migraine-like headaches.
Caffeine and ergotamine may also be used for purposes other than those listed in this medication guide.
Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with caffeine and ergotamine. In rare but severe cases, gangrene or other serious problems can result. Some, but not all, of these medications are listed below in the section "What other drugs will affect caffeine and ergotamine?”. Do not take any other medications during treatment with caffeine and ergotamine without first talking to your doctor.
Do not take caffeine and ergotamine without first talking to your doctor if you have:
-
peripheral vascular disease or poor circulation;
-
arteriosclerosis or "hardening of the arteries”;
-
high blood pressure;
-
heart disease;
-
liver disease;
-
kidney disease; or
-
a serious infection.
You may not be able to take caffeine and ergotamine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
Caffeine and ergotamine may pass into breast milk and harm a nursing infant.
Take caffeine and ergotamine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
Take caffeine and ergotamine at the first sign of an attack.
For the oral tablets, two tablets should be taken at the first sign of a vascular headache; followed by one additional tablet every half hour if needed, up to six tablets per attack.
Use the rectal suppositories as directed by your doctor. One suppository should be administered at the first sign of a vascular headache; followed by one additional suppository after one hour if needed, up to two suppositories per attack.
Do not use more than six tablets or two suppositories per headache. Do not use more than ten tablets or five suppositories in seven days. If your symptoms are not being adequately treated, talk to your doctor.
Store caffeine and ergotamine at room temperature away from moisture and heat.
Since caffeine and ergotamine is taken on an as-needed basis, missing a dose is not usually a problem.
Stop taking caffeine and ergotamine and seek emergency medical attention or contact your doctor immediately if you experience.
-
an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
-
chest pain;
-
numbness or tingling in the fingers or toes;
-
muscle pain in the arms or legs;
-
leg weakness;
-
changes in heart rate;
-
swelling; or
-
itching.
Other, less serious side effects may also occur. Continue to take caffeine and ergotamine and talk to your doctor if you experience nausea or vomiting.
Caffeine and ergotamine may be habit forming when used for long periods of time. Larger doses may be needed for headache relief, and withdrawal effects may occur when caffeine and ergotamine therapy is stopped.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with caffeine and ergotamine. In rare but severe cases, gangrene or other serious problems can result. Some, but not all, of these medications are listed below in the section "What other drugs will affect caffeine and ergotamine?”. Do not take any other medications during treatment with caffeine and ergotamine without first talking to your doctor.
Contact your doctor immediately if you experience numbness or tingling in the fingers or toes, chest pain, weakness of the legs, muscle pain in the arms or legs, pain in the chest, changes in heart rate, swelling or itching.
Do not use more than six tablets or two suppositories per headache. Do not use more than ten tablets or five suppositories in seven days. If your symptoms are not being adequately treated, talk to your doctor.
Do not take more than six tablets per headache. Do not take more than ten tablets in 7 days. If your symptoms are not being adequately treated, talk to your doctor.
Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with caffeine and ergotamine. In rare but severe cases, gangrene or other serious problems can result. The following drugs should not be taken with caffeine and ergotamine or should be used only under the close supervision of a doctor:
-
another medication that contains an ergot compound such as Ergomar, D.H.E., or D.H.E. Nasal;
-
another migraine headache medicine such as almotriptan (Axert), sumatriptan (Imitrex), zolmitriptan (Zomig), rizatriptan (Maxalt), or naratriptan (Amerge)—these medicines must not be taken within 24 hours of a dose of caffeine and ergotamine;
-
a selective serotonin reuptake inhibitor (SSRI) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), sertraline (Zoloft), or paroxetine (Paxil);
-
a beta-blocker (which are used to treat high blood pressure, irregular heartbeats, and other heart conditions) such as carteolol (Cartrol), carvedilol (Coreg), labetalol (Normodyne, Trandate), nadolol (Corgard), pindolol (Visken), propranolol (Inderal), sotalol (Betapace), or timolol (Blocadren);
-
an HIV/AIDS medicine such as amprenavir (Agenerase), delavirdine (Rescriptor), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), or saquinavir (Invirase, Fortovase);
-
the antibiotics erythromycin (Ery-Tab, E.E.S., E-Mycin, Eryc, others) or clarithromycin (Biaxin);
-
the antifungals medicines itraconazole (Sporanox) or ketoconazole (Nizoral);
-
nefazodone (Serzone);
-
cimetidine (Tagamet, Tagamet HB); or
-
sibutramine (Meridia).
The use of caffeine and ergotamine may be dangerous if you are taking any of the drugs listed above.
Drugs other than those listed here may also interact with caffeine and ergotamine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.
Seek emergency medical attention.
Symptoms of a caffeine and ergotamine overdose include nausea, vomiting, numbness in the fingers or toes, confusion, drowsiness, convulsions, and possibly death.
