Dihydroergotamine (dihydroergotamine mesylate)

• Migraine: people having a migraine attack, with or without aura (warning signs such as flashing lights before the headache), to treat the attack, not to prevent attacks.
• Cluster headache: people having cluster headache episodes (very painful headaches on one side of the head that come in groups), to treat an episode.

A prescription is required. Your prescriber decides whether Dihydroergotamine is right for you.

IV infusion, given by a healthcare professional.

Injection into a muscle, given by a healthcare professional.

Injection under the skin, given by a healthcare professional, or you or a caregiver after training.

If you have risk factors for heart disease, the label says to take the first dose in a medical office. Your prescriber decides whether you can give the shots yourself at home after training.

Storage: Store at room temperature, 68°F to 77°F, in the carton to protect it from light. Do not refrigerate or freeze.

Before the first dose, your prescriber may ask for:

• a clear diagnosis of migraine headache
• a heart check (cardiovascular evaluation) if you have risk factors for heart disease, such as high blood pressure, high cholesterol, smoking, obesity, diabetes, a strong family history, being a woman past menopause or being a man over 40
• a review of all your medicines, because it must not be used with strong CYP3A4 blockers, such as some HIV medicines, some antibiotics (like clarithromycin or erythromycin) and some antifungals (like ketoconazole or itraconazole)
• training on how to give the shot under the skin, if you will give it yourself

Important safety information: This medicine has a boxed warning about serious and life-threatening loss of blood flow (ischemia) to the brain, arms or legs when it is used with strong CYP3A4 blockers, such as some HIV medicines and some antibiotics. Using it with these medicines is not allowed.

Read the Medication Guide and the full Dihydroergotamine prescribing information, and ask your prescriber or our pharmacists about side effects. Our pharmacists are on call 24 hours a day.

Health plans often require prior authorization for Dihydroergotamine. Our intake team checks your coverage and works with your prescriber’s office on the paperwork before your first delivery.

Offices can call (844) 671-2600 or fax a referral to (844) 671-2601. Use the Migraine Referral Form (PDF).