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 - ORAL

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

COMMON BRAND NAME(S): Ercaf, Wigraine

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 take 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 taking this, lie down in a quiet, dark room for an hour or two. Make sure you understand how often to take this medication and the maximum amount of medication that should be taken (usually 6 per headache or 10 per week). Do not use daily on a regular basis. Do not take more than prescribed. Review your dosing directions with your doctor or pharmacist. Be sure to ask any questions you may have.

SIDE EFFECTS: May cause dizziness, drowsiness, stomach upset, anxiety, tremor. These effects should subside as your body adjusts to the medication. 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/coldness in the hands or feet, bluish discoloration of the fingers and toes, vision changes, depression. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Tell your doctor if you have: liver problems, kidney problems, blood vessel disease, high blood pressure, poor circulation, a severe infection, history of smoking/tobacco use, allergies (especially drug allergies). Avoid activities requiring alertness if dizziness or drowsiness occurs. Contact your doctor if you develop any kind of infection while taking this medication. This medication must not be used during pregnancy. If you become pregnant or think you may be pregnant, inform your doctor immediately. This medication may be excreted into breast milk and have undesirable effects on a nursing infant. Do not breast-feed without first consulting your doctor.

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 you take this medication, tell your doctor of any over-the-counter or prescription drugs you are taking, especially of: dopamine, nefazodone, fluconazole, fluoxetine, fluvoxamine, zileuton, metronidazole, clotrimazole, nicotine (e.g., tobacco, nicotine patches), caffeine, beta-blockers (e.g., labetalol, 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 alcohol while taking this medication as it will only make your headache worse. Avoid exposure to cold. If you take large doses of this medication for a long time, you may have a severe headache for a few days after stopping the drug. If the headache lasts for more than a few days, contact your doctor. Do not allow anyone else to take this medication.

MISSED DOSE: If you miss a dose, take as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

STORAGE: Store at room temperature away from sunlight and moisture.

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