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What should I discuss with my healthcare provider before taking ergotamine (Ergomar)?

Do not take this medication if you are allergic to ergotamine or similar medications such as Cafergot, D.H.E. 45, Migergot, Migranal, or Methergine.

Do not take ergotamine if you are pregnant or breast-feeding, or if you have:

• a history of heart disease, angina (chest pain), blood circulation problems, or history of a heart attack or stroke;
• coronary artery disease or "hardening of the arteries";
• uncontrolled high blood pressure;
• severe liver disease;
• severe kidney disease; or
• a serious infection called sepsis.

Using certain medications together with ergotamine can cause even greater decreases in blood flow than ergotamine used alone, which can lead to dangerous side effects. Do not take ergotamine if you are also using any of the following medications:

• conivaptan (Vaprisol), imatinib (Gleevec), isoniazid (for treating tuberculosis), or nefazodone (an antidepressant);
• diclofenac (Arthrotec, Cataflam, Voltaren, Flector Patch, Solareze);
• clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), or telithromycin (Ketek);
• clotrimazole (Mycelex Troche), itraconazole (Sporanox), ketoconazole (Extina, Ketozole, Nizoral, Xolegal), or voriconazole (Vfend);
• heart or blood pressure medication such as diltiazem (Cardizem, Dilacor, Tiazac), nicardipine (Cardene), quinidine (Quin-G), or verapamil (Calan, Covera, Isoptin, Verelan); or
• HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase, Fortovase), or ritonavir (Norvir).

Ergotamine can cause rare but serious side effects on the heart, including heart attack or stroke. To make sure you can safely take ergotamine, tell your doctor if you have any of these other conditions:

• high blood pressure;
• liver disease;
• kidney disease; or
• coronary artery disease (or risk factors that include diabetes, menopause, smoking, being overweight, having high blood pressure or high cholesterol, having a family history of coronary artery disease, being older than 40 and a man, or being a woman who has had a hysterectomy).

FDA pregnancy category X. Ergotamine can cause birth defects. Do not use if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.

Ergotamine can pass into breast milk and may harm a nursing baby. Ergotamine may also decrease milk production. Do not use if you are breast-feeding a baby.

How should I take ergotamine (Ergomar)?

Take exactly as prescribed by your doctor. Never take more than your prescribed dose of ergotamine. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in treating your migraine attacks. Ergotamine is not for daily use.

Take the first dose of ergotamine as soon as you notice headache symptoms, or after an attack has already begun. Place 1 ergotamine tablet under your tongue.

If your headache does not completely go away, you may take a second tablet after at least 30 minutes have passed, and a third tablet if needed after another 30 minutes have passed (a total of 3 tablets).

If you still have migraine symptoms after taking a total of 3 tablets, call your doctor. Do not take more than a total of 3 tablets in any 24-hour period. Do not take more than a total of 5 tablets over a period of 7 days.

Do not give this medication to anyone else, even if they have the same headache symptoms you have. Ergotamine can be dangerous if it is used to treat headache in a person who has not been diagnosed by a doctor as having true migraine headaches.

Store at room temperature away from moisture, heat, and light. Do not take any stored ergotamine if the expiration date on the label has passed.

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