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Ergotamine : Therapeutic uses, Dosage & Side Effects

Ergotamine (ergot alkaloid) is an ergopeptine & a partial agonists or antagonists at serotonergic, dopaminergic, and adrenergic receptors. It is useful in migraine.
Dose: 1-3 mg Oral / Sublingual, 0.25-0.5 mg I.M. / S.C.
Route: Oral, Sublingual, Intramuscular, Subcutaneous, Intravenous
Plasma half-life: 2 hours
Duration of action:
few hours
Bioavailability: 
Intravenous 100% , Intramuscular 47% , Oral <1% (Enhanced by co-administration of caffeine)
Chemical formula: 
C33H35N5O5
IUPAC name:
(6aR,9R)-N-((2R,5S,10aS,10bS)-5-Benzyl-10b-hydroxy-2-methyl-3,6-dioxooctahydro-2H-oxazolo[3,2-a]pyrrolo[2,1-c]pyrazin-2-yl)-7-methyl-4,6,6a,7,8,9-hexahydroindolo[4,3-fg]quinoline-9-carboxamide
Trade name: Ergotamine, Gynergen, Ingagen, Ergomar, Cafergot, Migril, Vsograin, Ergophen, Migergot (rectal suppositories)
Therapeutic uses:
Ergotamine is used to treat migraine (migraine headaches) because of vasoconstriction property that narrows blood vessels in the brain.
Side effects:  Adverse effects of Ergotamine are as follows:

  • Nausea,
  • Vomiting,
  • Numbness and tingling of fingers and toes,
  • Headache,
  • Precordial distress and pain suggestive of angina pectoris,
  • Transient tachycardia or bradycardia,
  • Localized edema and itching.

Contraindications:

  • The use of ergot alkaloids for migraine should be restricted to patients having frequent, moderate migraine or infrequent, severe migraine attacks.
  • Ergot alkaloids are contraindicated in women who are, or may become, pregnant because the drugs may cause fetal distress and miscarriage.
  • Ergot alkaloids also are contraindicated in patients with peripheral vascular disease, coronary artery disease, hypertension, impaired hepatic or renal function, and sepsis.
  • Ergot alkaloids should not be taken within 24 hours of the use of the triptans, and should not be used concurrently with other drugs that can cause vasoconstriction.
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