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Details

Stereochemistry ABSOLUTE
Molecular Formula C21H27N3O2.2C4H4O4
Molecular Weight 585.6023
Optical Activity UNSPECIFIED
Defined Stereocenters 3 / 3
E/Z Centers 2
Charge 0

SHOW SMILES / InChI
Structure of METHYSERGIDE DIMALEATE

SMILES

OC(=O)\C=C/C(O)=O.OC(=O)\C=C/C(O)=O.CC[C@@H](CO)NC(=O)[C@H]1CN(C)[C@@H]2CC3=CN(C)C4=C3C(=CC=C4)C2=C1

InChI

InChIKey=FUYUWMZGKBNTIB-VMTAUMJGSA-N
InChI=1S/C21H27N3O2.2C4H4O4/c1-4-15(12-25)22-21(26)14-8-17-16-6-5-7-18-20(16)13(10-23(18)2)9-19(17)24(3)11-14;2*5-3(6)1-2-4(7)8/h5-8,10,14-15,19,25H,4,9,11-12H2,1-3H3,(H,22,26);2*1-2H,(H,5,6)(H,7,8)/b;2*2-1-/t14-,15+,19-;;/m1../s1

HIDE SMILES / InChI

Molecular Formula C21H27N3O2
Molecular Weight 353.458
Charge 0
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 3 / 3
E/Z Centers 0
Optical Activity UNSPECIFIED

Molecular Formula C4H4O4
Molecular Weight 116.0722
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 1
Optical Activity NONE

Methysergide is an oral, synthetic ergot alkaloid, structurally related to the oxytocic agent methylergonovine and to the potent hallucinogen LSD. Methysergide is used prophylactically to reduce the frequency and intensity of severe vascular headaches. Although methysergide is an ergot alkaloid, it is a weak vasoconstrictor and oxytocic. Methysergide is a more potent antagonist of peripheral serotonin receptors than other ergot alkaloids. Methysergide is not just a 5HT2 antagonist, it is also a 5HT1 agonist. Although methysergide and sumatriptan both stimulate serotonin receptors centrally, methysergide is intended for prophylaxis while sumatriptan is indicated for treatment of an acute attack. Methysergide was approved by the FDA in 1962. Methysergide was formerly used for prophylaxis of cluster headaches/migraine headaches, but is no longer recommended due to retroperitoneal/retropulmonary fibrosis.

Originator

Curator's Comment: Methysergide was introduced in the clinic in 1959 as a highly specific 5-HT antagonist in the preventive treatment of migraine by the Italian neurologist Federigo Sicuteri

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Preventing
SANSERT

Approved Use

For the prevention or reduction of intensity and frequency of vascular headaches in the following kinds of patients: Patients suffering from one or more severe vascular headaches per week. Patients suffering from vascular headaches that are uncontrollable or so severe that preventive therapy is indicated regardless of the frequency of the attack.

Launch Date

1962
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
5 nM
2 mg single, oral
dose: 2 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
METHYSERGIDE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
33 nM
0.753 mg single, intravenous
dose: 0.753 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
METHYSERGIDE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
563.9 nM × min
2 mg single, oral
dose: 2 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
METHYSERGIDE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
2027 nM × min
0.753 mg single, intravenous
dose: 0.753 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
METHYSERGIDE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
62 min
2 mg single, oral
dose: 2 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
METHYSERGIDE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
45 min
0.753 mg single, intravenous
dose: 0.753 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
METHYSERGIDE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
15 mg 1 times / day multiple, oral
Studied dose
Dose: 15 mg, 1 times / day
Route: oral
Route: multiple
Dose: 15 mg, 1 times / day
Sources:
unhealthy, 17 - 24 years
Health Status: unhealthy
Age Group: 17 - 24 years
Sources:
10 |5 mg 1 times / day multiple|multiple, oral|intravenous
Dose: 10 |5 mg, 1 times / day
Route: oral|intravenous
Route: multiple|multiple
Dose: 10 |5 mg, 1 times / day
Sources:
unhealthy, 17 - 24 years
Health Status: unhealthy
Age Group: 17 - 24 years
Sources:
10 |5| 2 mg 1 times / day multiple|multiple|single, oral|intravenous|intrathecal
Dose: 10 |5| 2 mg, 1 times / day
Route: oral|intravenous|intrathecal
Route: multiple|multiple|single
Dose: 10 |5| 2 mg, 1 times / day
Sources:
unhealthy, 17 - 24 years
Health Status: unhealthy
Age Group: 17 - 24 years
Sex: M+F
Sources:
0.753 mg 1 times / day single, intravenous
Dose: 0.753 mg, 1 times / day
Route: intravenous
Route: single
Dose: 0.753 mg, 1 times / day
Sources:
healthy, 23-28 years
Health Status: healthy
Age Group: 23-28 years
Sex: M
Sources:
8 mg 1 times / day multiple, oral
Dose: 8 mg, 1 times / day
Route: oral
Route: multiple
Dose: 8 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sources:
Disc. AE: Vomiting, Cramps...
AEs leading to
discontinuation/dose reduction:
Vomiting
Cramps
Peripheral vasoconstriction (severe)
Sources:
AEs

AEs

AESignificanceDosePopulation
Cramps Disc. AE
8 mg 1 times / day multiple, oral
Dose: 8 mg, 1 times / day
Route: oral
Route: multiple
Dose: 8 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sources:
Vomiting Disc. AE
8 mg 1 times / day multiple, oral
Dose: 8 mg, 1 times / day
Route: oral
Route: multiple
Dose: 8 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sources:
Peripheral vasoconstriction severe
Disc. AE
8 mg 1 times / day multiple, oral
Dose: 8 mg, 1 times / day
Route: oral
Route: multiple
Dose: 8 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sources:
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG

OverviewOther

Other InhibitorOther SubstrateOther Inducer

Drug as perpetrator​Drug as victim
PubMed

PubMed

TitleDatePubMed
Abdominal angina as a complication of methysergide maleate therapy.
1967 Jan 9
Silent retroperitoneal fibrosis associated with methysergide therapy.
1968 Oct 28
Cardiac murmurs and endocardial fibrosis associated with methysergide therapy.
1974 Nov
Methysergide in the treatment of narcolepsy.
1975 Apr
Skeletal muscle necrosis following membrane-active drugs plus serotonin.
1976 May
Methysergide-induced heart disease: a case of multivalvular and myocardial fibrosis.
1977 Nov
Migraine and systemic scleroderma.
1978 Apr
[Methysergide-induced fibrosis. Directives for preventive treatment of migraine with methysergide].
1979 Jan 29
The influence of 5-HT receptor blocking agents on the behavioral effects of analgesics in rats.
1980
Methysergide induced mitral valvular insufficiency.
1980 Jan
[Distal mesenteric arteritis: a rare complication of D. methylsergide treatment (author's transl)].
1981 Apr
[Reversible distal mesenteric arteritis after continuous prolonged treatment with methylsergide].
1981 Mar 21
Arterial complications of migraine treatment with methysergide and parenteral ergotamine.
1982 Jul 24
[Sclerodermiform syndrome caused by methysergide].
1984 Apr 7
Simulation of acute myopericarditis by constrictive pericardial disease with endomyocardial fibrosis due to methysergide therapy.
1984 Jul
Chronic pain after methysergide: a new cause of ischemic monomelic neuropathy.
1991 Nov-Dec
Molecular cloning of a serotonin receptor from human brain (5HT1E): a fifth 5HT1-like subtype.
1992 Jun 15
Two members of a distinct subfamily of 5-hydroxytryptamine receptors differentially expressed in rat brain.
1993 Apr 15
Profile of capsaicin-induced mouse ear oedema as neurogenic inflammatory model: comparison with arachidonic acid-induced ear oedema.
1993 Dec
Cloning and expression of a novel serotonin receptor with high affinity for tricyclic psychotropic drugs.
1993 Mar
Effect of nondopaminergic drugs on L-dopa-induced dyskinesias in MPTP-treated monkeys.
1993 Oct
A useful method for differential evaluation of anti-inflammatory effects due to cyclooxygenase and 5-lipoxygenase inhibitions in mice.
1994 Aug
Cloning and characterisation of the human 5-HT5A serotonin receptor.
1994 Dec 5
Serotonin syndrome complicating migraine pharmacotherapy.
1996 Aug
Alniditan, a new 5-hydroxytryptamine1D agonist and migraine-abortive agent: ligand-binding properties of human 5-hydroxytryptamine1D alpha, human 5-hydroxytryptamine1D beta, and calf 5-hydroxytryptamine1D receptors investigated with [3H]5-hydroxytryptamine and [3H]alniditan.
1996 Dec
Two amino acid differences in the sixth transmembrane domain are partially responsible for the pharmacological differences between the 5-HT1D beta and 5-HT1E 5-hydroxytryptamine receptors.
1996 Nov
Functional and radioligand binding characterization of rat 5-HT6 receptors stably expressed in HEK293 cells.
1997 Apr-May
Mast cell involvement in the rat paw oedema response to 1,8-cineole, the main constituent of eucalyptus and rosemary oils.
1997 Jul 23
Involvement of 5-hydroxytryptamine and bradykinin in the hyperalgesia induced in rats by collagenase from Clostridium histolyticum.
1997 May
Cloning, expression and pharmacology of a truncated splice variant of the human 5-HT7 receptor (h5-HT7b).
1997 Sep
Interaction of tryptamine and ergoline compounds with threonine 196 in the ligand binding site of the 5-hydroxytryptamine6 receptor.
1997 Sep
Activating mutations of the serotonin 5-HT2C receptor.
1997 Sep
Effects of EGIS-7625, a selective and competitive 5-HT2B receptor antagonist.
2003 Sep-Nov
Pharmacological characterisation of the agonist radioligand binding site of 5-HT(2A), 5-HT(2B) and 5-HT(2C) receptors.
2004 Aug
Binding of tryptamine analogs at h5-HT1E receptors: a structure-affinity investigation.
2004 May 15
[Neuromediatorial mechanisms of analgesia during general anesthesia].
2004 May-Jun
Methysergide-induced scleroderma-like changes of the legs.
2005 Jul
[3H]LY334370, a novel radioligand for the 5-HT1F receptor. I. In vitro characterization of binding properties.
2005 Mar
Potential vascular alpha1-adrenoceptor blocking properties of an array of 5-HT receptor ligands in the rat.
2006 Mar 27
Drug-induced fibrotic valvular heart disease.
2009 Aug 15
Patents

Sample Use Guides

In Vivo Use Guide
Usual adult dose 4-8 mg daily. Tablets to be given with meals
Route of Administration: Oral
In Vitro Use Guide
Curator's Comment: Constriction measurements and intracellular microelectrode recordings were performed in vitro on lymphatic vessels isolated from the guinea-pig mesentery to investigate whether 5-hydroxytryptamine (5-HT) affected lymphatic pumping and smooth muscle membrane potential. 5-HT decreased in a concentration-dependent manner the frequency of constrictions induced by intraluminal vessel perfusion. In nonperfused vessels, 5-HT hyperpolarized the lymphatic smooth muscle membrane potential and decreased the frequency and amplitude of spontaneous transient depolarizations (STDs).
The actions of 5-HT were significantly reversed by the 5-HT(1/2/5/7) receptor antagonist methysergide (0.5 uM)
Substance Class Chemical
Created
by admin
on Mon Mar 31 21:08:11 GMT 2025
Edited
by admin
on Mon Mar 31 21:08:11 GMT 2025
Record UNII
EMS84N8S7Y
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
METHYSERGIDE DIMALEATE
Common Name English
ERGOLINE-8-CARBOXAMIDE, 9,10-DIDEHYDRO-N-(1-(HYDROXYMETHYL)PROPYL)-1,6-DIMETHYL-, (8.BETA.(S))-, (2Z)-2-BUTENEDIOATE (1:2) (SALT)
Preferred Name English
ERGOLINE-8-CARBOXAMIDE, 9,10-DIDEHYDRO-N-(1-(HYDROXYMETHYL)PROPYL)-1,6-DIMETHYL-, (8.BETA.(S))-, (Z)-2-BUTENEDIOATE (1:2) (SALT)
Systematic Name English
Code System Code Type Description
CAS
120220-03-3
Created by admin on Mon Mar 31 21:08:11 GMT 2025 , Edited by admin on Mon Mar 31 21:08:11 GMT 2025
PRIMARY
PUBCHEM
21158509
Created by admin on Mon Mar 31 21:08:11 GMT 2025 , Edited by admin on Mon Mar 31 21:08:11 GMT 2025
PRIMARY
FDA UNII
EMS84N8S7Y
Created by admin on Mon Mar 31 21:08:11 GMT 2025 , Edited by admin on Mon Mar 31 21:08:11 GMT 2025
PRIMARY
Related Record Type Details
PARENT -> SALT/SOLVATE
Related Record Type Details
ACTIVE MOIETY