Dihydroergotamine

Dihydroergotamine is a drug that is used to treat migraines and cluster headaches. In the past, the remedy was also prescribed to prevent flare-ups. This field of application is no longer permissible today due to the side effects of the drug. Dihydroergotamine has an inhibitory effect on certain receptors in the brain and can thus reduce the sensation of pain.

What is Dihydroergotamine?

Dihydroergotamine is known under the trade names Ergont®, Detemes®, Ergotam®, Agilan®, Verladyn® or Migrana®l, among others. The active ingredient is used to treat migraines, cluster headaches and so-called hypotonic circulatory disorders.

Cluster headaches are also known as histamine headaches. Characteristic for this clinical picture are mostly unilateral extremely severe pain around the eye. Hypotonic circulatory disorders are disorders of the organism whose functional impairment is due to low blood pressure.

Dihydroergotamine is a so-called ergot alkaloid. Ergot alkaloids are organic compounds and are mostly found in the ergot fungus Claviaceps purpurea. This fungus grows as a parasite on grasses and grains such as rye. These compounds and individual partial sequences have been used as medicinal products since the 18th century. They are also part of certain chemically produced drugs. Dihydroergotamine is a prescription drug.

Pharmacological effect

Dihydroergotamine is a substance that has an antagonistic effect. Antagonists occupy receptors in the brain and have an inhibiting effect on the transmission of signals from certain stimuli to the associated cells.

Dihydroergotamine couples to the dopamine, serotonin and adrenoreceptors. The ergot alkaloid has an inhibitory effect on neuronal receptors. In this context, dihydroergotamine lowers the development of pain, which is also caused by these receptors.

In the human organism, the simultaneous intake of macrolide antibiotics can lead to undesirable interactions. Therefore, these active ingredients should not be administered together. Macrolide antibiotics are drugs that prevent bacteria from growing and / or multiplying.

Medical application & use

The active ingredient dihydroergotamine is used in medicine in the treatment of acute migraine attacks. In the past, the medicine was also used to prevent those attacks. However, it is no longer approved as a prophylactic agent in the European Union.

The drug is also used in some countries to treat dementia. The alkaloid has also been used to treat low blood pressure and lymphatic insufficiency. With the latter disease, the transport of lymph fluid is restricted due to a disturbance in the circulation. As a result, severe changes to the skin and veins can occur.

After a decision by the Federal Institute for Drugs and Medical Devices, the drug is no longer used for the treatment of these diseases due to its unfavorable risk-benefit ratio.

Dihydroergotamine is administered in the form of tablets, drops or capsules in oral form. In addition, the medicine can be taken nasally or orally with the help of inhalers. Injection is also possible. Studies have shown that the medical device can be absorbed better in the body in oral form than via inhalation.

Risks & side effects

Taking dihydroergotamine can lead to risks and side effects. Nausea, restlessness and headaches were often described. Other possible risks such as circulatory disorders or angina pectoris were observed. But these are rather rare. Angina pectoris is a symptom that usually occurs as a result of a circulatory disorder in the coronary arteries.

Since the drug can cause life-threatening reactions, it was banned in January 2014 as a prophylactic agent for migraines and other diseases. Dihydroergotamine can cause fibrosis in certain organs. In the case of fibrosis, organ tissues become hardened by collagen fibers. In the long term, this leads to massive restrictions in the function of the affected organs and can be fatal.

In addition, the body can be poisoned by the ergot alkaloid. Dihydroergotamine must not be taken if triptans have been prescribed at the same time. Triptans are also used in the treatment of migraines and cluster headaches.