Dihydroergotamine is a drug that is used to treat migraines and cluster headaches. In the past, the drug was also prescribed for the prevention of migraine attacks. This field of application is no longer permitted today due to the side effects of the drug. Dihydroergotamine exerts an inhibitory effect at certain receptors in the brain and can thus reduce the sensation of pain.
What is dihydroergotamine?
Dihydroergotamine is known by the trade names Ergont, Detemes, Ergotam, Agilan, Verladyn, or Migranal, among others. The drug is used to treat migraines, cluster headaches, and so-called hypotonic circulatory disorders. Cluster headaches are also known as histamine headaches. Characteristic of this clinical picture are mostly unilateral extremely strong pains around the eye. Hypotonic circulatory disorders are disorders of the organism whose diminished functions are caused by low blood pressure. Dihydroergotamine is a so-called ergot alkaloid. Ergot alkaloids are organic compounds and are mostly found in the ergot fungus Claviaceps purpurea. This fungus grows as a parasite on grasses and cereals such as rye. Since the 18th century, these compounds and individual partial sequences from them have been used as medicines. They are also a component of certain chemically produced drugs. Dihydroergotamine is a prescription drug.
Pharmacologic action
Dihydroergotamine is a substance that has an antagonistic effect. Antagonists occupy receptors in the brain and have an inhibitory effect on the signal transduction of certain stimuli to the associated cells. Dihydroergotamine couples to the dopamine, serotonin and adrenoreceptors. The ergot alkaloid exerts an inhibitory effect at neuronal receptors. In this context, dihydroergotamine reduces the development of pain, which is partly caused by these receptors. In the human organism, undesirable interactions may occur if macrolide antibiotics are taken at the same time. Therefore, these agents should not be administered together. Macrolide antibiotics are drugs that prevent bacteria from growing and/or multiplying.
Medicinal use and application
The active ingredient dihydroergotamine is used in medicine in the treatment of acute migraine attacks. In the past, the drug was also used to prevent those attacks. However, it is no longer approved as a prophylactic agent in the European Union. The drug is also used in some countries for the treatment of dementia. Furthermore, the alkaloid has been used to treat low blood pressure and lymphatic insufficiency. In the latter disease, due to a disturbance of the circulation, the transport of lymphatic fluid is restricted. As a result, severe changes can occur in the skin and veins. Following a decision by the German Federal Institute for Drugs and Medical Devices, the drug is no longer used for the treatment of these diseases due to its unfavorable risk-benefit ratio. Dihydroergotamine is administered in the form of tablets, drops or capsules in oral form. In addition, the drug can be taken nasally or orally with the aid of inhalers. Injection is also possible. Studies have shown that the medical product can be better absorbed in the body in oral form than via inhalation.
Risks and side effects
Taking dihydroergotamine may cause risks and side effects. Nausea, restlessness, and headache have often been described. Other possible risks, such as circulatory problems or angina, have been observed. However, these are rather rare. Angina pectoris is a symptom that usually occurs as a result of a circulatory disorder in the coronary arteries. Because the drug can cause life-threatening reactions, it was banned in January 2014 as a prophylactic medication for migraines and other conditions. Dihydroergotamine can cause fibrosis in certain organs. Fibrosis involves the hardening of organ tissues by collagen fibers. In the long term, this leads to massive restrictions in the function of the affected organs and can have a fatal outcome. In addition, poisoning of the body by the ergot alkaloid is possible.Dihydroergotamine should not be taken if triptans have been prescribed at the same time. Triptans are also used in the treatment of migraine and cluster headaches.
