Ergotamine/caffeine explained
| Type: | combo |
| Component1: | Ergotamine |
| Class1: | vasoconstrictor, neurotransmitter agonist and antagonist |
| Component2: | Caffeine |
| Class2: | vasoconstrictor, phosphodiesterase inhibitor |
| Tradename: | Cafergot, Migergot, others |
| Dailymedid: | Ergotamine and caffeine |
| Pregnancy Au: | C |
| Pregnancy Category: | Contraindicated |
| Routes Of Administration: | By mouth, rectal |
| Atc Prefix: | N02 |
| Atc Suffix: | CA52 |
| Legal Us: | Rx-only |
| Legal Us Comment: | [1] [2] |
| Cas Number: | 69063-86-1 |
| Kegg: | D07600 |
Ergotamine/caffeine, sold under the brand name Cafergot among others, is a fixed-dose combination medication used for the treatment of migraine. It contains ergotamine, as the tartrate, an alpha adrenergic blocking agent; and caffeine, a cranial vasoconstrictor.[3]
Ergotamine/caffeine is available as a generic medication.
Medical uses
Ergotamine/caffeine is indicated as therapy to abort or prevent vascular headache.
Mechanism of action
Ergotamine binds to 5HT 1b/d receptors.[4] This along with binding to other serotonergic and dopaminergic receptors is their presumed mechanism of action in treating migraine.[4] [5]
Adverse effects
Because the vasoconstrictive effects of ergotamine and caffeine are not selective for the brain, adverse effects due to systemic vasoconstriction can occur. Cold feet or hands, angina pectoris, myocardial infarction,[6] or dizziness are some examples.
It has also been shown to be associated with mitral valve stenosis. [7]
Notes and References
- Web site: Cafergot- ergotamine tartrate and caffeine tablet, film coated. DailyMed . U.S. National Library of Medicine. live. https://web.archive.org/web/20140116115705/http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=b4a06de6-f837-43a8-ae7a-aadb38dd2a7d . 16 January 2014.
- Web site: Migergot- ergotamine tartrate and caffeine suppository . DailyMed . 29 November 2022 . 18 May 2024.
- Diener HC, Jansen JP, Reches A, Pascual J, Pitei D, Steiner TJ . Efficacy, tolerability and safety of oral eletriptan and ergotamine plus caffeine (Cafergot) in the acute treatment of migraine: a multicentre, randomised, double-blind, placebo-controlled comparison . European Neurology . 47 . 2 . 99–107 . 2002 . 11844898 . 10.1159/000047960 . 72629130 .
- Web site: Acute treatment of migraine in adults . 15 January 2018 . UpToDate . . 27 March 2018.
- Fanciullacci M, Granchi G, Sicuteri F . Ergotamine and methysergide as serotonin partial agonists in migraine . Headache . 16 . 5 . 226–231 . November 1976 . 977328 . 10.1111/j.1526-4610.1976.hed1605226.x . 45861917 .
- Book: The Headaches . 3rd . Olesen J, Goadsby PJ, Ramadan NM, Tfelt-Hansen P, Michael K, Welch A . 2006 . Lippincott Williams and Wilkins . 978-0781754002 . 463 .
- Austin SM, el-Hayek A, Comianos M, Tamulonis DJ . Mitral valve disease associated with long-term ergotamine use . Southern Medical Journal . 86 . 10 . 1179–1181 . October 1993 . 8211344 . 10.1097/00007611-199310000-00024 .
