Dihydroergocryptine: Effects, Uses & Risks

Dihydroergocryptine is an active ingredient derived from ergot alkaloids. For use, the drug is primarily used against Parkinson’s disease.

What is dihydroergocryptine?

Dihydroergocryptine is primarily used for Parkinson’s disease. Dihydroergocryptin (DHEC) is a drug used to treat Parkinson’s disease (shaking paralysis). The drug is derived from ergot alkaloids. The substance can be used primarily as a dopamine D2 agonist as well as a D1 partial agonist. In Germany and Switzerland, the drug is marketed under the name a-dihydroergocryptine mesilate. In commerce, dihydroergocryptine is offered as Almirid and Cripar. Dihydroergocryptine was developed in the 1990s. The Italian company Poli was responsible for it. The drug was intended for the treatment of migraine and Parkinson’s disease. Later, the licenses were passed on to companies in Switzerland and Germany. The efficacy of dihydroergocryptine with regard to Parkinson’s disease and migraine was confirmed by various studies. In addition, studies were conducted for the treatment of Restless Legs Syndrome (RLS). However, approval for the treatment of this disease failed to materialize.

Pharmacologic effect

Dihydroergocryptine is chemically classified as an ergot alkaloid. Some substances from this group are able to mimic the effects of the neurotransmitter dopamine in the human brain. Thus, they can bind to the brain nerve cell receptor as dopamine receptor agonists. In this way, the same effects can be triggered as by dopamine. Dihydroergocryptin has a particularly positive effect on Parkinson’s symptoms such as tremor and rigidity of movement, which are the result of dopamine deficiency. Unlike other Parkinson’s drugs, however, DHEC cannot bind to the receptors of the neurotransmitters adrenaline and serotonin. This has the advantage, however, that few psychological side effects are threatened by taking the drug.

Medical application and use

The most important area of application of dihydroergocryptin is Parkinson’s disease. Thus, the drug is used to improve the mobility of the patient. This receives by the administration of the drug more freedom of movement and can cope with everyday tasks again more easily. DHEC is often taken together with the Parkinson’s drug levodopa. In addition, dihydroergocryptine is also administered for interval treatment of migraine headaches. The dosage of dihydroergocryptine depends on the disease being treated. In Parkinson’s disease, the initial dose per day is 10 milligrams. As treatment progresses, the dosage can be increased by 10 milligrams per week until the required maintenance dose is finally achieved. This is usually 60 milligrams per day. In individual cases, 120 milligrams can also be administered. The daily dose is divided into two doses. If migraine headaches are to be treated with DHEC, the dose also starts at 10 milligrams per day. After two weeks, the necessary maintenance limit is 20 milligrams daily. Even if DHEC therapy is successful, it is recommended that treatment be discontinued after a period of six months. Only in the event of a relapse is it considered advisable to resume taking the dihydroergocryptin. The application of the tablets also takes place twice a day.

Risks and side effects

In some cases, patients may suffer from unwanted side effects from taking dihydroergocryptine. These primarily include stomach pain and nausea. Also common are headaches, dizziness, heartburn, vomiting, stomach cramps, circulatory problems, restlessness, rapid heartbeat, sleep disturbances, a dry mouth, feelings of weakness, a drop in blood pressure, changes in weight, and water retention in the tissues (edema). Furthermore, occasional restlessness, ringing in the ears, nasal congestion, muscle cramps, cold sensations or tingling in the limbs, movement disorders, constipation, loss of appetite, tremors, nightmares, fatigue, and loss of libido may occur. Delusions are also within the realm of possibility in isolated cases. The described side effects usually depend on the level of the DHEC dose. If it is reduced, the side effects also decrease.The most frequent contraindications to the use of DHEC include hypersensitivity to dihydroergocryptine or ergot alkaloids. Likewise, therapy with the active ingredient is not recommended in cases of advanced liver damage, psychoses that cannot be physically justified, low blood pressure or concurrent treatment with antihypertensive drugs. DHEC is also considered unsuitable during pregnancy and breastfeeding. In pregnant women, for example, there is a risk of inducing premature labor. There is also a risk of inhibition of milk secretion. Dihydroergocryptin must also not be administered to children. Taking Dihydroergocryptin may have a negative effect on other medicines. For example, the positive effects of drugs that increase blood pressure are weakened. On the other hand, however, the effect of antihypertensive drugs is strengthened. Furthermore, the agglomeration of platelets is impaired by DHEC, making the blood more fluid. For this reason, patients who are simultaneously taking medications that affect blood clotting are advised to undergo regular medical checks. Some physicians also suspect that dihydroergocryptine has a potentiating effect on psychotropic drugs. Dihydroergocryptin can be negatively influenced by other substances in medications. For example, taking levodopa at the same time can lead to more frequent headaches, stomach pain and low blood pressure. Furthermore, it is not advisable to administer DHEC together with other ergot alkaloids, as the side effects of the preparations are more pronounced as a result. It is also not advisable to take alcohol at the same time, because the tolerance of dihydroergocryptine is negatively affected by alcohol consumption.