Cafergot (Ergotamine Tartrate and Caffeine) Drug Information: Side Effects and Drug Interactions

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May 25, 2012

Cafergot

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Migraine is a serious, potentially life-threatening neurological disease that affects nearly 32 million Americans, the majority of whom are women. The hallmark symptom of migraine is an escalating, often unbearable, debilitating headache that is commonly described as intense throbbing or pulsating pain in one area of the head. The pain may be accompanied by extreme sensitivity to light and sound, nausea, and vomiting. In some people, migraines are preceded by visual disturbances known as auras that may include flashing lights, zigzag lines, or temporary blindness.

Migraine medications do not cure migraines. Instead, migraine drugs treat the symptoms using one of two approaches. Some migraine drugs relieve symptoms. Other migraine drugs are used to prevent a migraine attack.

Many migraine sufferers rely on simple pain relievers to get through an attack. These range from over-the-counter analgesics like acetaminophen to an...

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SIDE EFFECTS

Cardiovascular: Vasoconstrictive complications of a serious nature may occur at times. These include ischemia, cyanosis, absence of pulse, cold extremities, gangrene, precordial distress and pain, EKG changes and muscle pains. Although these effects occur most commonly with long-term therapy at relatively high doses, they have also been reported with short-term or normal doses. Other cardiovascular adverse effects include transient tachycardia or bradycardia and hypertension.

Gastrointestinal: Nausea and vomiting.

Neurological: paresthesias, numbness, weakness, and vertigo.

Allergic: Localized edema and itching.

Fibrotic Complications

(see WARNINGS).

Drug Abuse And Dependence: There have been reports of drug abuse and psychological dependence in patients on CAFERGOT® (ergotamine tartrate and caffeine) (ergotamine tartrate and caffeine tablets, USP) therapy. Due to the chronicity of vascular headaches, it is imperative that patients be advised not to exceed recommended dosages with long-term use to avoid ergotism (see PRECAUTIONS).

DRUG INTERACTIONS

CYP 3A4 Inhibitors (e.g., Macrolide Antibiotics and Protease Inhibitors): See CONTRAINDICATIONS and WARNINGS.

CAFERGOT® (ergotamine tartrate and caffeine tablets, USP) should not be administered with other vasoconstrictors. Use with sympathomimetics (pressor agents) may cause extreme elevation of blood pressure. The beta-blocker Inderal (propranolol) has been reported to potentiate the vasoconstrictive action of CAFERGOT® (ergotamine tartrate and caffeine tablets, USP) by blocking the vasodilating property of epinephrine. Nicotine may provoke vasoconstriction in some patients, predisposing to a greater ischemic response to ergot therapy.

The blood levels of ergotamine-containing drugs are reported to be elevated by the concomitant administration of macrolide antibiotics and vasospastic reactions have been reported with therapeutic doses of the ergotamine-containing drugs when coadministered with these antibiotics.

Last reviewed on RxList: 9/30/2008
This monograph has been modified to include the generic and brand name in many instances.