Generic
Caffeine + Ergotamine Tartrate
2 brands available in the market
At a glance
Caffeine + Ergotamine Tartrate is a combination medicine used in the treatment of acute migraine attacks. Ergotamine constricts blood vessels in the head, and caffeine enhances its absorption, helping to relieve migraine pain.
Description
Caffeine + Ergotamine Tartrate is a combination medicine used for the treatment of acute migraine attacks. Ergotamine is an ergot alkaloid that prevents the dilation of blood vessels in the head, reducing migraine pain. Caffeine increases the absorption of ergotamine and further helps to constrict widened blood vessels.
Migraine is believed to be caused by electrical and chemical imbalances affecting brain blood vessels, increasing pain sensitivity and causing inflammation and swelling. This medication is most effective when taken at the first sign of a migraine attack.
Indications
- Migraine
- Vascular headache
Therapeutic class
Antimigraine Agent
Pharmacological class
Ergot Alkaloid + Xanthine Combination
Pharmacology
Ergotamine tartrate is an ergot alkaloid that acts directly on vascular smooth muscle to cause vasoconstriction. It constricts intracranial blood vessels that are dilated during migraine, thereby relieving pain. Caffeine is a methylxanthine that stimulates the central nervous system and enhances the absorption and bioavailability of ergotamine.
Mechanism of action
Ergotamine constricts dilated cranial blood vessels by acting on smooth muscle, reducing migraine pain. Caffeine enhances this effect by increasing ergotamine absorption and further constricting blood vessels.
Dosage
Adults and children above 12 years:
Take 1-2 tablets at the first sign of a migraine attack.
If necessary, take 1-2 tablets every 30-60 minutes.
Maximum dose: No more than 4-6 tablets per day; no more than 8-10 tablets per week.
Note: Not for chronic daily use. Do not exceed the recommended dosage for migraine treatment.
Administration
Take at the first sign of a migraine attack, with or without food. Swallow tablets whole; do not chew or crush. It is better to take it at a fixed time each day.
Missed dose
If you miss a dose, take it as soon as you remember. Skip the missed dose if it is almost time for your next dose and continue with your regular schedule. Do not double the dose.
Side effects
Common side effects: Nausea, vomiting, diarrhea, muscle pain, increased heart rate, restlessness.
Serious side effects: Numbness or tingling in fingers and toes, muscle pain in arms and legs, weakness in legs, chest pain, changes in heart rate, swelling or itching.
Long-term use: Retroperitoneal fibrosis, pleuropulmonary fibrosis, fibrotic thickening of heart valves (rare).
Signs of ergotism: Intense arterial vasoconstriction, peripheral vascular ischemia, numbness, coldness, pallor of digits (may lead to gangrene).
Precautions & warnings
- Do not exceed recommended dosage; not for chronic daily use.
- Rebound headache may occur upon discontinuation (rare).
- Do not use during pregnancy and lactation.
- Caution in patients with liver and kidney disease.
- Avoid in peripheral vascular disease, coronary heart disease, hypertension, and sepsis.
Contraindications
- Hypersensitivity to ergotamine or caffeine
- Peripheral vascular disease, obliterative vascular disease
- Coronary heart disease
- Uncontrolled hypertension
- Severe hepatic and renal impairment
- Pregnancy and lactation
- Raynaud's disease
- Concomitant use with potent CYP3A4 inhibitors (macrolide antibiotics, protease inhibitors)
Drug interactions
- Strong CYP3A4 inhibitors (macrolide antibiotics like erythromycin, clarithromycin; protease inhibitors like ritonavir, indinavir): May cause severe ergot toxicity (ergotism); coadministration is contraindicated.
- Less potent CYP3A4 inhibitors (fluconazole, fluoxetine, grapefruit juice, metronidazole): Potential risk of vasospasm; caution required.
- Other vasoconstrictors and sympathomimetics: May cause extreme elevation of blood pressure.
- Propranolol (beta-blocker): May potentiate ergotamine's vasoconstrictive effect.
- Nicotine: May increase vasoconstriction.
Food interactions
Alcohol consumption is unsafe (may trigger migraines and increase side effects).
Use in pregnancy
Highly unsafe during pregnancy (Category X). Ergotamine can cause uterine contractions and fetal harm. Contraindicated in pregnant women.
Pregnancy Category: X — always consult a doctor before taking during pregnancy.
Use in lactation
Unsafe during breastfeeding. The drug may pass into breast milk and harm the baby. Contraindicated in nursing mothers.
Pediatric use
Not recommended for children under 12 years of age.
Geriatric use
Use with caution in elderly patients (higher risk of cardiovascular and vascular disease).
Renal / hepatic impairment
Renal impairment: Contraindicated in severe kidney disease.
Overdose effects
Overdose symptoms: Nausea, vomiting, abdominal pain, increased heart rate, dizziness, drowsiness, confusion, convulsions, unconsciousness. Consult your doctor immediately if overdose is suspected.
Storage conditions
Store below 30°C, away from light and moisture. Keep out of reach of children.
Chemical structure
Ergotamine Tartrate 1 mg + Caffeine 100 mg