Adult Dosing
Migraine headaches
- 1 mg IV/IM/SC
- Repeat dose as needed at 1hr intervals up to 3 mg for IM or SC, or up to 2 mg IV, in a 24 hr period
- Max: 6 mg/wk
Cluster headache
- 1 mg IV/IM/SC
- Repeat dose as needed at 1hr intervals up to 3 mg for IM or SC, or up to 2 mg IV, in a 24 hr period
- Max: 6 mg/wk
Note: Dihydroergotamine should not be used for chronic daily administration
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Serious and/or life-threatening peripheral ischemia may occur when co-administered with potent CYP3A4 inhibitors including protease inhibitors and macrolide antibiotics; Avoid using CYP3A4 inhibitors with dihydroergotamine [US Black Box Warning]
- Prolonged use of therapy may cause pleural, retroperitoneal fibrosis, also; rare cases of cardiac valvular fibrosis have been reported
- Avoid using therapy in patient with unrecognized coronary artery disease (CAD) and other cardiovascular disorder
- First dose of therapy should always be administered in physician's office or similar medically staffed and equipped facility
- Long term users of this therapy and patients who have, or acquire risk factors predictive of CAD should undergo cardiovascular evaluation to continue the use of therapy
- Serious adverse cardiac events, including acute myocardial infarction, life-threatening disturbances of cardiac rhythm, and death have been reported while on therapy
- Patients treated with dihydroergotamine have reported cerebral hemorrhage, subarachnoid hemorrhage, stroke, and other cerebrovascular events
- Patients with migraine are at increased risk of certain cerebrovascular events such as stroke, hemorrhage, transient ischemic attack
- Therapy may cause vasospastic reactions other than coronary artery vasospasm. Myocardial, peripheral vascular, and colonic ischemia have been reported.
- Therapy associated vasospastic phenomena may cause muscle pains, numbness, coldness, pallor, and cyanosis of the digits. Discontinue the therapy if signs or symptoms of vasoconstriction develop
- Rare cases of increase in blood pressure has been reported in patients with and without a history of hypertension treated with dihydroergotamine
Cautions: Use cautiously in:
- Elderly patients
- Cardiac disorders
- Less potent CYP 3A4 inhibitors
Supplemental Patient Information
- Patients should not take dihydroergotamine within 2 weeks of using MAO inhibitors or within 24 hours of using ergot-type/ ergotamine-containing drugs or 5HT-1 agonists.
Pregnancy Category:X
Breastfeeding: This drug is excreted in human milk, as it inhibits prolactin; but there are no data on the concentration of dihydroergotamine in human milk. Ergotamine is excreted in breast milk and may cause vomiting, diarrhea, weak pulse, and unstable blood pressure in nursing infants. Because of the potential for these serious adverse events in nursing infants exposed to dihydroergotamine, nursing should be avoided.
US Trade Name(s)
US Availability
dihydroergotamine (generic)
D.H.E. 45
Canadian Trade Name(s)
Canadian Availability
dihydroergotamine (generic)
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
Dihydergot
- SOLN for INJ: 1 mg/mL (amp)
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- D.H.E. 45 1 MG/ML SOLN [Ampule] (VALEANT)
5 ml = $661.42
15 ml = $1935.43
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
