Intranasal Dihydroergotamine

Aka: Intranasal Dihydroergotamine, Migranal

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II. Indications

  1. Migraine Abortive Management

III. Efficacy

  1. Significant Migraine response in 30 minutes
    1. Migranal: 70%
    2. Placebo: 28%
  2. Reference
    1. Gallagher (1996) Arch Neurol 53:1285-91 [PubMed]

IV. Dosing

  1. Prepare sprayer by inserting ampule and prime pump
  2. Use one spray each nostril
  3. May repeat x1 after 15 minutes (Total dose = 2mg)
  4. Maximum use is 2 times per week

V. Advantages

  1. Lasts longer than intranasal Imitrex
  2. Rebound Headache less common than Imitrex
    1. Rebound HeadacheIncidence: 15% within 24 hours
  3. Less expensive than Intranasal Imitrex ($16/dose)

VI. Disadvantages

  1. Does not work as fast as intranasal Imitrex
  2. More complicated to use than intranasal Imitrex

VII. Adverse Effects

  1. Rhinitis
  2. Nausea
  3. Taste perversion

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