DIHYDROERGOTAMINE

Details

Stereochemistry	ABSOLUTE
Molecular Formula	C33H37N5O5
Molecular Weight	583.6774
Optical Activity	UNSPECIFIED
Defined Stereocenters	7 / 7
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure Search

SMILES

[H][C@@]12CCCN1C(=O)[C@H](CC3=CC=CC=C3)N4C(=O)[C@](C)(NC(=O)[C@H]5CN(C)[C@]6([H])CC7=CNC8=C7C(=CC=C8)[C@@]6([H])C5)O[C@@]24O

InChI

InChIKey=LUZRJRNZXALNLM-JGRZULCMSA-N

InChI=1S/C33H37N5O5/c1-32(35-29(39)21-15-23-22-10-6-11-24-28(22)20(17-34-24)16-25(23)36(2)18-21)31(41)38-26(14-19-8-4-3-5-9-19)30(40)37-13-7-12-27(37)33(38,42)43-32/h3-6,8-11,17,21,23,25-27,34,42H,7,12-16,18H2,1-2H3,(H,35,39)/t21-,23-,25-,26+,27+,32-,33+/m1/s1

HIDE SMILES / InChI

Description
Sources: https://www.ncbi.nlm.nih.gov/pubmed/12558771 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf

Dihydroergotamine (DHE) is a semisynthetic, hydrogenated ergot alkaloid, synthesized by reducing an unsaturated bond in ergotamine. Dihydroergotamine was originally envisaged as an antihypertensive agent, but it was later shown to be highly effective in treating migraine. Dihydroergotamine was first used to treat migraine in 1945 by Horton, Peters, and Blumenthal at the Mayo Clinic. In 1986, Raskin and Callaham reconfirmed the effectiveness of DHE for both intermittent and intractable migraine. The use of DHE was reviewed by Scott in 1992. In 1997, a nasal spray version was approved for use in migraine. Dihydroergotamine is indicated for the acute treatment of migraine headaches with or without aura and the acute treatment of cluster headache episodes. Dihydroergotamine binds with high affinity to 5-HT1Dα and 5-HT1Dβ receptors. It also binds with high affinity to serotonin 5-HT1A, 5-HT2A, and 5-HT2C receptors, noradrenaline α2A, α2B and α, receptors, and dopamine D2L and D3 receptors. The therapeutic activity of dihydroergotamine in migraine is generally attributed to the agonist effect at 5-HT1D receptors. Two current theories have been proposed to explain the efficacy of 5-HT1D receptor agonists in migraine. One theory suggests that activation of 5-HT1D receptors located on intracranial blood vessels, including those on arterio-venous anastomoses, leads to vasoconstriction, which correlates with the relief of migraine headache. The alternative hypothesis suggests that activation of 5-HT1D receptors on sensory nerve endings of the trigeminal system results in the inhibition of proinflammatory neuropeptide release.

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Potency
Serotonin 1d (5-HT1d) receptor 52 Target ID: CHEMBL1983 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/9605573 \| https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2678	0.5 nM [IC50]
Serotonin 1b (5-HT1b) receptor 46 Target ID: CHEMBL1898 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/9605573 \| https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2678	0.7 nM [IC50]
Serotonin 1a (5-HT1a) receptor 172 Target ID: CHEMBL214 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2678	0.4 nM [IC50]
Serotonin 2a (5-HT2a) receptor 231 Target ID: CHEMBL224 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2678	9.0 nM [IC50]
Serotonin 2c (5-HT2c) receptor 124 Target ID: CHEMBL225 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2678	1.3 nM [IC50]
Serotonin 1f (5-HT1f) receptor 15 Target ID: CHEMBL1805 Sources: https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2678	180.0 nM [IC50]

Conditions

Condition	Modality	Targets	Highest Phase	Product
Migraine 103 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	Primary		Approved 8429	D.H.E. 45 Approved Use Dihydroergotamine Mesylate Injection, USP is indicated for the acute treatment of migraine headaches with or without aura and the acute treatment of cluster headache episodes. Launch Date 1946

C_max

Value	Dose	Co-administered	Analyte	Population
1.02 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8841149/	1 mg single, nasal dose: 1 mg route of administration: Nasal experiment type: SINGLE co-administered:		DIHYDROERGOTAMINE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN

AUC

Value	Dose	Co-administered	Analyte	Population
5.05 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8841149/	1 mg single, nasal dose: 1 mg route of administration: Nasal experiment type: SINGLE co-administered:		DIHYDROERGOTAMINE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN

T_1/2

Value	Dose	Co-administered	Analyte	Population
7.952 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8841149/	1 mg single, nasal dose: 1 mg route of administration: Nasal experiment type: SINGLE co-administered:		DIHYDROERGOTAMINE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN

F_unbound

Value	Dose	Co-administered	Analyte	Population
7% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8841149/	1 mg single, nasal dose: 1 mg route of administration: Nasal experiment type: SINGLE co-administered:		DIHYDROERGOTAMINE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN

Doses

Dose	Population	Adverse events
2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	Disc. AE: Rhinitis, Dizziness... AEs leading to discontinuation/dose reduction: Rhinitis (2 patients) Dizziness (2 patients) Edema face (1 patient) Cold sweat (1 patient) Trauma (1 patient) Depression (1 patient) Somnolence (1 patient) Allergy (1 patient) Vomiting (1 patient) Hypotension (1 patient) Paraesthesia (1 patient) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
4 mg 1 times / day steady, intranasal Highest studied dose Dose: 4 mg, 1 times / day Route: intranasal Route: steady Dose: 4 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	unhealthy, adult Health Status: unhealthy Condition: migraine Age Group: adult Sex: unknown Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf
1 mg single, subcutaneous Recommended Dose: 1 mg Route: subcutaneous Route: single Dose: 1 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	unhealthy, adult Health Status: unhealthy Condition: migraine Age Group: adult Sex: unknown Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	Disc. AE: Cerebrovascular event... AEs leading to discontinuation/dose reduction: Cerebrovascular event (grade 5) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf
1 mg 1 times / day steady, subcutaneous (max) Recommended Dose: 1 mg, 1 times / day Route: subcutaneous Route: steady Dose: 1 mg, 1 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/	unhealthy, adult n = 51 Health Status: unhealthy Condition: migraine Age Group: adult Sex: unknown Population Size: 51 Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/	Disc. AE: Nausea, Vomiting... AEs leading to discontinuation/dose reduction: Nausea (20 patients) Vomiting (3 patients) Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/

AEs

AE	Significance	Dose	Population
Allergy	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Cold sweat	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Depression	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Edema face	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Hypotension	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Paraesthesia	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Somnolence	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Trauma	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Vomiting	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Dizziness	2 patients Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Rhinitis	2 patients Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years n = 1796 Health Status: unhealthy Condition: migraine Age Group: 18 - 65 years Sex: M+F Population Size: 1796 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Cerebrovascular event	grade 5 Disc. AE	1 mg single, subcutaneous Recommended Dose: 1 mg Route: subcutaneous Route: single Dose: 1 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	unhealthy, adult Health Status: unhealthy Condition: migraine Age Group: adult Sex: unknown Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf
Nausea	20 patients Disc. AE	1 mg 1 times / day steady, subcutaneous (max) Recommended Dose: 1 mg, 1 times / day Route: subcutaneous Route: steady Dose: 1 mg, 1 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/	unhealthy, adult n = 51 Health Status: unhealthy Condition: migraine Age Group: adult Sex: unknown Population Size: 51 Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/
Vomiting	3 patients Disc. AE	1 mg 1 times / day steady, subcutaneous (max) Recommended Dose: 1 mg, 1 times / day Route: subcutaneous Route: steady Dose: 1 mg, 1 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/	unhealthy, adult n = 51 Health Status: unhealthy Condition: migraine Age Group: adult Sex: unknown Population Size: 51 Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
substrate 1737

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
P-gp 1461 MATE1 306 MATE2 263 OCT2 647

Drug as perpetrator

Target	Modality	Activity
MATE2 263	inhibitor 3277 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068829/	yes [IC50 12.6 uM]
MATE1 308	inhibitor 3277 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068829/	yes [IC50 2.8 uM]
OCT2 648	inhibitor 3277 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068829/	yes [IC50 49.9 uM]
P-gp 1650	inhibitor 3277 Sources: https://jpet.aspetjournals.org/content/303/1/323.long Page: 5.0	yes [Ki 120 uM]

Drug as victim

Target	Modality	Activity	Metabolite	Clinical evidence
CYP3A4 1737	substrate 3367 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC152687/	yes

Sourcing

Vendor/Aggregator	ID	URL
ChEBI	CHEBI:4562	https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:4562
ZINC	ZINC000003978005	http://zinc15.docking.org/substances/ZINC000003978005

PubMed

Title	Date	PubMed
How it started.	2001	11678811
Management of hot flashes in breast-cancer survivors.	2001 Apr	11905764
[Ormond's fibrosis, bone osteolysis and stomach intramural metastases in the course f low-differentiated prostatic cancer].	2001 Jul	11928571
The outcome of treating patients with suspected rebound headache.	2001 Jul-Aug	11554956
Treatment of childhood headaches.	2001 Mar	11898510
Saint-Anthony's fire.	2001 Nov 17	11728546
Comparison of intravenous valproate versus intramuscular dihydroergotamine and metoclopramide for acute treatment of migraine headache.	2001 Nov-Dec	11903525
Migraines.	2001 Nov-Dec	11801805
[Headaches caused by abuse of symptomatic anti-migraine and analgesic treatment].	2001 Oct	11885515
Advances in pharmacological treatment of migraine.	2001 Oct	11772289
A simple thin-layer chromatographic method for the detection of ergovaline in leaf sheaths of tall fescue (Festuca arundinacea) infected with Neotyphodium coenophialum.	2001 Sep	11580073
Postoperative ileus: progress towards effective management.	2002	12466000
An introduction to migraine: from ancient treatment to functional pharmacology and antimigraine therapy.	2002	12434581
[Acute renal failure caused by dihydroergotamine].	2002	12123131
Practical approaches to migraine management.	2002	12027785
Efficacy, tolerability and safety of oral eletriptan and ergotamine plus caffeine (Cafergot) in the acute treatment of migraine: a multicentre, randomised, double-blind, placebo-controlled comparison.	2002	11844898
Frovatriptan: a review of drug-drug interactions.	2002 Apr	12028322
Specific labelling of serotonin 5-HT(1B) receptors in rat frontal cortex with the novel, phenylpiperazine derivative, [3H]GR125,743. A pharmacological characterization.	2002 Apr	11888550
Successful treatment of threatening limb loss ischemia of the upper limb caused by ergotamine. A case report and review of the literature.	2002 Apr	11887064
Therapeutic strategies for orthostatic intolerance: mechanisms, observations, and making patients feel better.	2002 Apr 1	11904120
Comparative effects of clonidine and dihydroergotamine on venomotor tone and orthostatic tolerance in patients with severe hypoadrenergic orthostatic hypotension.	2002 Apr 1	11904110
Valvular heart disease in patients taking pergolide.	2002 Dec	12479512
Fibrosis due to ergot derivatives: exposure to risk should be weighed up.	2002 Dec	12472101
The antimigraine 5-HT 1B/1D receptor agonists, sumatriptan, zolmitriptan and dihydroergotamine, attenuate pain-related behaviour in a rat model of trigeminal neuropathic pain.	2002 Dec	12466238
Management of the acute migraine headache.	2002 Dec 1	12484694
Ergotamine-induced anorectal strictures: report of five cases.	2002 Feb	11852344
Naratriptan in the prophylaxis of cluster headache.	2002 Jan	12005276
Syndrome of cerebrospinal fluid hypovolemia following lumbar puncture cerebrospinal fluid leak in a patient with idiopathic intracranial hypertension.	2002 Jan	11913582
Possible ergotamine-caffeine-associated delirium.	2002 Jan	11794425
[Migraine: a disease, not a symptom].	2002 Jan 1	11852766
[Treatment of migraine in patients with hypertension and ischemic heart disease].	2002 Jan 20	12122940
[Critical ischaemia of the limbs and localized livedo in a case of ergotism].	2002 Jan 25	11807658
The effect of rizatriptan, ergotamine, and their combination on human peripheral arteries: a double-blind, placebo-controlled, crossover study in normal subjects.	2002 Jul	12100223
Fatal ergotism induced by an HIV protease inhibitor.	2002 Jul-Aug	12482227
Endocardial myxomatous change in Harlan Sprague-Dawley rats (Hsd:S-D) and CD-1 mice: its microscopic resemblance to drug-induced valvulopathy in humans.	2002 Jul-Aug	12187939
Endocrine and respiratory responses to ergotamine in Brahman and Hereford steers.	2002 Jun	12046966
Cardiovascular, respiratory, and body temperature responses of sheep to the ergopeptides ergotamine and ergovaline.	2002 Mar	11911573
New treatments in cluster headache.	2002 Mar	11898477
Treatment patterns of isolated benign headache in US emergency departments.	2002 Mar	11867972
Sensitive and specific liquid chromatographic-tandem mass spectrometric assay for dihydroergotamine and its major metabolite in human plasma.	2002 Mar 5	11888055
[Use and misuse of triptans: a case report].	2002 Mar-Apr	12185976
Incidence and determinants of migraine prophylactic medication in the Netherlands.	2002 May	12012149
Fibrotic valvular heart disease subsequent to bromocriptine treatment.	2002 Nov-Dec	12390688
Efficacy and tolerability of prochlorperazine buccal tablets in treatment of acute migraine.	2002 Oct	12390617
[Ergotism in a patient treated with ritonavir and ergotamine].	2002 Oct 26	12421531
Hemicrania continua: a report of ten new cases.	2002 Sep	12364931
Drug combinations in the therapy of low response to phosphodiesterase 5 inhibitors in patients with erectile dysfunction.	2002 Sep-Oct	12494876
Crossover comparison of efficacy and preference for rizatriptan 10 mg versus ergotamine/caffeine in migraine.	2003	12464714
Pharmacological characterization of 5-HT(1B) receptor-mediated inhibition of local excitatory synaptic transmission in the CA1 region of rat hippocampus.	2003 Jan	12522075
Variations among emergency departments in the treatment of benign headache.	2003 Jan	12514688

Patents

Sample Use Guides

In Vivo Use Guide

Usual Adult Dose for Migraine IM or subcutaneous: Initial dose: 1 mg given as quickly as possible after the first symptom of headache. Additional 1 mg doses can be given hourly until the headache has stopped or a total dose of 3 mg has been reached. The total weekly dose should not exceed 6 mg. IV: Initial dose: 1 mg given as quickly as possible after the first symptom of headache. Additional 1 mg doses can be given hourly until the headache has stopped or a total dose of 2 mg has been reached. The total weekly dose should not exceed 6 mg. Intranasal: 1 spray (0.5 mg) into each nostril (total = 1 mg). Repeat if needed within 15 minutes to a maximum of 4 sprays (2 mg) per day. The total weekly dose should not exceed 8 sprays (4 mg). Usual Adult Dose for Cluster Headache IM or subcutaneous: Initial dose: 1 mg given as quickly as possible after the first symptom of headache. Additional 1 mg doses can be given hourly until the headache has stopped or a total dose of 3 mg has been reached. The total weekly dose should not exceed 6 mg. IV: Initial dose: 1 mg given as quickly as possible after the first symptom of headache. Additional 1 mg doses can be given hourly until the headache has stopped or a total dose of 2 mg has been reached. The total weekly dose should not exceed 6 mg.

Route of Administration: Other

In Vitro Use Guide

Dihydroergotamine (DHE) (EC(50)=10.9+/-0.3 nM) and 8'-OH-DHE (EC(50)=30.4+/-0.8 nM) inhibited the firing of serotoninergic neurons in the rat dorsal raphe nucleus within brain stem slices.

Name

Type

Language

DIHYDROERGOTAMINE

Official Name

English

DHE

Common Name

English

NEOMIGRAN

Brand Name

English

MAP-0004

Code

English

DIHYDROERGOTAMINE [MART.]

Common Name

English

(10α)-5′α-benzyl-12′-hydroxy-2′-methyl-3′,6′,18-trioxo-9,10-dihydroergotaman

Systematic Name

English

MAP0004

Code

English

DIHYDROERGOTAMINE [VANDF]

Common Name

English

9,10-DIHYDROERGOTAMINE

Common Name

English

DIHYDROERGOTAMINE [MI]

Common Name

English

dihydroergotamine [INN]

Common Name

English

CODERGOCRINE MESILATE IMPURITY D [EP IMPURITY]

Common Name

English

(5′α,10α)-9,10-Dihydro-12′-hydroxy-2′-methyl-5′-(phenylmethyl)ergotaman-3′,6′,18-trione

Systematic Name

English

Dihydroergotamine [WHO-DD]

Common Name

English

Classification Tree Code System Code

WHO-VATC

QN02CA01