MIGRIL CAFERGOT TAGRIL

Dose: 1 to 2 mg
Single Dose: 1.5 (1.5)
Frequency: As recommended.
Route: IM
Instructions: Initially as Required

Ergotamine (Tartrate) also known as Cafergot, Cafergot, Cafergot. . It is of Synthetic origin and belongs to Ergot Alkaloid. It belongs to Serotonin agonsit pharmacological group on the basis of mechanism of action and also classified in Analgesics and Anti-inflammatory Agents and Ergot Derivative pharmacological group.The Molecular Weight of Ergotamine (Tartrate) is 1313.43. Its pKa is 6.8.

Ergotamine (Tartrate) is contraindicated in conditions like Hypertension,Renal diseases,Hepatic disease,Chronic pulmonary disease,Vascular disease,Collagen disease,Valvular heart disease,Cachexia.

The severe or irreversible adverse effects of Ergotamine (Tartrate), which give rise to further complications include Ventricular fibrillation, Retroperitoneal fibrosis, Pleuropulmonary fibrosis, Endocardial fibrosis, Cerebral hemorrhage, Stroke.Ergotamine (Tartrate) produces potentially life-threatening effects which include Myocardial infarction, Renal failure, Vascular occlusions, Necrosis of bowel, Gangrene of extremities. which are responsible for the discontinuation of Ergotamine (Tartrate) therapy.The signs and symptoms that are produced after the acute overdosage of Ergotamine (Tartrate) include Nausea, Vomiting, Tachycardia, Diarrhea, Coma, Confusion, Pallor, Cold extremities.The symptomatic adverse reactions produced by Ergotamine (Tartrate) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Weakness, Nausea, Vomiting, Abdominal pain, Numbness, Cyanosis, Muscle pain, Oedema, Poresthesia.

Ergotamine (Tartrate) is primarily indicated in conditions like Migraine, Prophylactic treatment of vascular headache, Vascular headaches.

Ergotamine (Tartrate) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAdrenalineAdditive vasoconstriction result due to alpha adrenergic agonist activity of ergotamine and hence increases blood pressure when given with adrenaline. ModerateExcessive vasoconstriction,patient response and tolerance should be monitor.AlmotriptanAmitriptyline (HCl)reports of serotonin syndrome in patients recieving ergotamine with amitriptyline , imipramine, paroxetine, or sertralineAmprenavirIncreased risk of ergotism when Amprenavir given with Ergotamine. ADVICE: Avoid concomitant use.MajorAzithromycinClarithromycinClarithromycin increases the plasma concentration of ergotamine by inhibiting hepatic metabolism.MajorCoadministration is considered contraindicated. Azithromycin is considered safer alternative of clarithromycin.EphedrineErgotamine significantly increases the blood pressure by synergistic vasoconstriction due to alpha adrenergic agonist activity of ephedrine.ModerateClinical monitoring of response, tolerence and excessive vasoconstriction is recommended. Patient advised to notify if numbness,tingling,muscle pain,weakness and chest pain signs appears.Erythromycinacute reactions ranging from minor ergotism to sever vasospasmMajorErythromycinErythromycin increases plasma concentration of ergotamine by inhibitiing CYP450 3A4 responsible for metabolic clearance of ergotamine.Ergotamine Toxicity occursMajorCoadministration of erythromycin and ergotamine is contraindicated.Glyceryl Trinitrateglyceryl trinitrate increase oral bioavailibilty and plasma concentration of dihydroergotamine in patients with orthostatic hypotensionIndinavir (Sulphate)Co administration increases the plasma concentrations of ergot derivatives by inhibiting the enzyme responsible for metabolic clearance.MajorCo administration is considered contraindicated.MetaraminolErgotamine significantly increases the blood pressure by synergistic vasoconstriction due to alpha adrenergic agonist activity of metaraminol.ModerateClinical monitoring of response, tolerence and excessive vasoconstriction is recommended. Patient advised to notify if numbness,tingling,muscle pain,weakness and chest pain signs appears.Methysergide (Hydrogen Maleate)arterial occlusion has been reported in patients given methysergide witha a high parenteral dosage of ergotamine for cluster headache.coadministration should be avoidedNaratriptanConcurrent use have been reported to cause prolonged vasospastic reactions. Concurrent use is not recommended.NelfinavirNevirapinePhenylephrine (HCl)Ergotamine significantly increases the blood pressure by synergistic vasoconstriction due to alpha adrenergic agonist activity of phenylephrine.ModerateClinical monitoring of response, tolerence and excessive vasoconstriction is recommended. Patient advised to notify if numbness,tingling,muscle pain,weakness and chest pain signs appears.Propranolol (HCl)Propranolol increases the risk of arteriospasm associated with ergotamine may lead to peripheral ischemia, hypertension with chest pain and migraine.ModerateIncreases the awareness of interaction.RitonavirSumatriptanBoh drugs acts additively thus coadministration potentiate the risk of vasospastic reaction, coronary artery vasospasm, peripheral vascular ischemia and colonic ischemia.MajorCoadministration of these agents is considered contraindicated.Tacrolimusergotamine may inhibit the metabolism of tacrolimus VORICONAZOLEVoriconazole may increase the serum concentration of ergotamine by decreasing its metabolism. .Concomitant therapy is contraindicated These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

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Drug should not be given to Paediatrics, Pregnant Mothers, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

Aerosol Protect from Sunlight. Suppositories Store Below 30°C. Protect from Sunlight. Tab Store at room temperature, Below 25°C. Protect from Sunlight and Moisture.

Avoid prolong administration or excessive dosage of ergotamine because of danger of gangrene, ergotism and patients become dependent upon it. It is Contraindicated in Pregnancy Risk of renal Vasoconstriction Avoid in liver impairment