ergotamine (Ergostat)

Introduction

Tradename: Ergostat.

Indications

• prevention & treatment of vascular headache (migraine)
• irritable bowel syndrome

Contraindications

• peripheral vascular disease
• hepatic disease or renal disease
• hypertension
• peptic ulcer disease
• sepsis
• avoid use during pregnancy

Dosage

• 2 mg SL, may repeat every 30 min X 2
• Max 5 tabs/week

Tabs: 2 mg.

Pharmacokinetics

• absorption increases with caffeine coadministration
• metabolized by liver
• metabolites eliminated in the bile

elimination via liver

Adverse effects

• tachycardia
• bradycardia
• arterial spasm
• claudication
• vasoconstriction
• rebound headache may occur with sudden withdrawal
• localized edema
• numbness & paresthesias of fingers & toes

Drug interactions

• propranolol in combination may result in severe vasoconstriction
• erythromycin & clarithromycin in combination may result in ergot toxicity

• drug interaction(s) of beta-adrenergic receptor antagonists with ergot alkaloids

Mechanism of action

• direct stimulation of vascular smooth muscle
• vasoconstriction of peripheral & cerebral vessels
• antagonism of serotonin activity

More general terms

• ergot alkaloid
• anti-migraine agent

Component of

• belladonna alkaloid/ergotamine/phenobarbital
• belladonna alkaloid/caffeine/ergotamine/phenobarbital
• belladonna alkaloid/caffeine/ergotamine/pentobarbital
• caffeine/ergotamine/pentobarbital (Cafergot PB)
• belladonna/ergotamine/phenobarbital (Bellergal-S, Spastrin)
• caffeine/ergotamine (Cafergot, Ercaf, Wigraine)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3251