IMPORTANT NOTE: The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.

ERGOTAMINE WITH CAFFEINE - RECTAL

(er-GOT-uh-meen WITH kaff-EEN)

COMMON BRAND NAME(S): Cafergot, Migergot

WARNING: Infrequently, a very serious, life-threatening decrease in the amount of blood supply to the hands and feet (peripheral ischemia) and rarely to the brain can occur when this medication is taken with drugs that affect liver metabolism (e.g., potent CYP 3A4 enzyme inhibitors). Do not take this medication with macrolide antibiotics (e.g., erythromycin, clarithromycin, troleandomycin), protease inhibitors (e.g., ritonavir, nelfinavir, indinavir, amprenavir, saquinavir), azole antifungals (e.g., ketoconazole, itraconazole).

USES: Ergotamine acts to reduce pulsing of migraine headaches. Caffeine is added to enhance the effects of ergotamine. The combination is used to treat migraine and cluster headaches.

HOW TO USE: It is best to use this medication at the first sign of a headache. It will take longer to work if taken when the headache has already become severe. After using this, lie down in a quiet, dark room for an hour or two. Do not use more than 2 suppositories per attack or more than 5 suppositories in a week. Do not use daily on a regular basis. Review your dosing directions with your doctor or pharmacist. To use suppositories, unwrap it and moisten it slightly with water. Lie on your left side with your right knee bent. Push the suppository well into the rectum with your finger. Try to avoid having a bowel movement for at least one hour to allow the medication to be absorbed. Insert a second suppository if headache is not relieved after one hour.

SIDE EFFECTS: May cause dizziness, drowsiness, stomach upset, anxiety, tremor. These effects should subside as your body adjusts to the medication. Avoid activities requiring alertness if dizziness or drowsiness occurs. Tell your doctor immediately if you have any of these unlikely but serious side effects: chest pain, irregular heartbeat, vomiting, muscle pain or numbness, pain/tingling or coldness in the hands or feet, bluish discoloration of the fingers and toes. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Avoid alcohol while taking this medication as it will only make your headache worse. Tell your doctor if you have any form of: blood vessel disease, liver or kidney disease, severe itching, high blood pressure, history of smoking/tobacco use, problems with circulation. Be sure to take this medication exactly as prescribed. Do not exceed recommended dosage. This medication should not be used during pregnancy. If you become pregnant or think you may be pregnant, inform your doctor immediately. This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: This drug should not be used with the following medications because very serious interactions may occur: macrolide antibiotics (e.g., erythromycin, clarithromycin, troleandomycin), protease inhibitors (e.g., ritonavir, nelfinavir, indinavir, amprenavir, saquinavir), azole antifungals (e.g., ketoconazole, itraconazole), telithromycin, delavirdine, efavirenz, voriconazole, sibutramine, dexfenfluramine, fenfluramine, "triptan" migraine drugs (e.g., sumatriptan). If you are currently using any of these medications, tell your doctor or pharmacist before starting this medication. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of: dopamine, nefazodone, fluconazole, fluoxetine, fluvoxamine, zileuton, metronidazole, clotrimazole, caffeine, beta-blockers (e.g., atenolol, propranolol), nitrates (e.g., isosorbide, nitroglycerin), other mild CYP 3A4 enzyme inhibitors. Consult your pharmacist for more information. Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor instructs you otherwise. Do not start or stop any medicine without doctor or pharmacist approval.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include nausea; diarrhea; vomiting; numbness, tingling, and bluish discoloration of fingers and toes; drowsiness; and seizures.

NOTES: Avoid exposure to cold. Be sure to mention any other diseases you have or other medication you take.

MISSED DOSE: Take the missed dose as soon as remembered but not if it is almost time for the next dose. If so, skip the missed dose and resume your regular schedule. Do not "double-up" the doses.

STORAGE: Store below 77 degree F (25 degree C) away from heat and sunlight. Do not store in the bathroom.

Developed by First DataBank, Inc., San Bruno, CA
Copyright 2004 by First DataBank, Inc.