D. H. E. 45 (Dihydroergotamine) Drug Information: Description, User Reviews, Drug Side Effects, Interactions

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February 10, 2012

DHE 45

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What is a migraine headache?

A migraine headache is a form of vascular headache. Migraine headache is caused by vasodilatation (enlargement of blood vessels) that causes the release of chemicals from nerve fibers that coil around the large arteries of the brain. Enlargement of these blood vessels stretches the nerves that coil around them and causes the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the arteries magnifies the pain.

Migraine attacks commonly activate the sympathetic nervous system in the body. The sympathetic nervous system is often thought of as the part of the nervous system that controls primitive responses to stress and pain, the so-called "fight or flight" response, and this activation causes many of the symptoms associated with migraine attacks; for example, the increased sympathetic n...

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D. H. E. 45

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D.H.E. 45
(dihydroergotamine mesylate) Injection, USP

WARNING
Serious and/or life-threatening peripheral ischemia has been associated with the coadministration of DIHYDROERGOTAMINE with potent CYP 3A4 inhibitors including protease inhibitors and macrolide antibiotics. Because CYP 3A4 inhibition elevates the serum levels of DIHYDROERGOTAMINE, the risk for vasospasm leading to cerebral ischemia and/or ischemia of the extremities is increased. Hence, concomitant use of these medications is contraindicated. (See also CONTRAINDICATIONS and WARNINGS section)

DRUG DESCRIPTION

D.H.E. 45 (dihydroergotamine) ® is ergotamine hydrogenated in the 9, 10 position as the mesylate salt. D.H.E. 45 (dihydroergotamine) ® is known chemically as ergotaman-3',6',18-trione,9,10-dihydro-12'-hydroxy-2'-methyl-5'- (phenylmethyl) (5'a)-, monomethanesulfonate. Its molecular weight is 679. 80 and its empirical formula is C₁₃H₃₇N₅O₅ · CH₄O₃S. Its chemical structure is:

D.H.E. 45® (dihydroergotamine mesylate) Injection, USP is a clear, colorless solution supplied in sterile ampuls for I.V., I.M. , or subcutaneous administration containing per mL:

dihydroergotamine mesylate, USP .................................. 1 mg

methanesulfonic acid/sodium hydroxide, qs to ..................pH 3.6 ± 0. 4

alcohol USP ...................................................................6.1 % by vol.

glycerin, UP ...................................................................15% by wt.

water for injection, USP , qs to ...................................... 1 ml .

What are the possible side effects of dihydroergotamine injection (D.H.E. 45)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using dihydroergotamine and call your doctor at once if you have a serious side effect such as:

fast or slow heart rate;
chest pain or heavy feeling, pain spreading to the arm or shoulder, and nausea, sweating, or general ill feeling;
sudden numbness or weakness, especially on one side of the body;
sudden...

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What are the precautions when taking dihydroergotamine (D. H. E. 45)?

Before using this medication, tell your doctor or pharmacist if you are allergic to it; or to other ergot alkaloids (e.g., ergotamine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: blood circulation disease (e.g., peripheral vascular disease such as arteriosclerosis, thrombophlebitis, Raynaud's disease), uncontrolled high blood pressure, heart/blood vessel disease (e.g., coronary artery disease, stroke, angina, heart attack), liver disease, kidney disease, severe blood infection (sepsis), recent blood...

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Last reviewed on RxList: 12/8/2004
This monograph has been modified to include the generic and brand name in many instances.