CAFFEINE AND ERGOTAMINE (ORAL/RECTAL)

(KAF een and er GOT a meen) Brand: Cafergot, Migergot

What is the most significant information I must know about caffeine and ergotamine?

• This medicine can harm an unborn child or reason birth defects. Do not use if you are pregnant.

• You must not use caffeine and ergotamine if you have coronary heart malady, tall blood pressure, circulation problems, liver or kidney malady, or a serious infection called sepsis.

• Some medicines can reason a dangerous decrease in blood flow when used with caffeine and ergotamine. A severe decrease in blood flow to the brain and another parts of the body can lead to dangerous side effects.

• Tell your doctor about all medicines you use, and those you start or stop using, especially: atazanavir, boceprevir, clarithromycin, delavirdine, fosamprenavir, imatinib, indinavir, isoniazid, itraconazole, ketoconazole, nefazodone, nelfinavir, nicardipine, posaconazole, quinidine, ritonavir, saquinavir, telaprevir, telithromycin, or voriconazole.

What is caffeine and ergotamine?

• Caffeine is a stimulant that causes narrowing of blood vessels (vasoconstriction).

• Ergotamine is in a group of drugs called ergot alkaloids (ER-got AL-ka-loids). It works by narrowing the blood vessels near the brain. Ergotamine also affects blood flow patterns that are associated with determined types of headaches.

• Caffeine and ergotamine is a combination medication used to treat or prevent a migraine type headache.

• This medicine will only treat a headache that has already begun. It will not prevent migraine headaches or reduce the number of attacks.

• Caffeine and ergotamine must not be used to treat general tension headaches or any headache that seems to be various from your normal migraine headaches.

• Caffeine and ergotamine may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till using caffeine and ergotamine ?

• You must not use this medication if you are allergic to caffeine or ergotamine, if you are pregnant, or if you have:

· coronary heart disease;

· tall blood pressure;

· blood circulation problems;

· liver disease;

· kidney malady; or

· a serious infection called sepsis.

· imatinib;

· isoniazid;

· nefazodone;

· an antibiotic--clarithromycin, telithromycin;

· antifungal medication--itraconazole, ketoconazole, posaconazole, voriconazole;

· heart medication--nicardipine, quinidine;

· hepatitis C medications--boceprevir, telaprevir; or

· HIV/AIDS medication--atazanavir, delavirdine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir.

• FDA pregnancy category X. This medicine can harm an unborn child or reason birth defects. Do not use caffeine and ergotamine if you are pregnant. Speak your doctor right away if you become pregnant during treatment. Use effective birth control while you are using this medication.

• Caffeine and ergotamine can pass into breast milk and may harm a nursing child. You must not breast-feed while using this medicine.

How must I use caffeine and ergotamine?

• Follow all directions on your prescription label. Never use more than your recommended dose. Overuse of migraine headache medication can create headaches worse. Speak your doctor if the medication seems to stop working as well in treating your migraine attacks. This medication is not for daily use.

• To use caffeine and ergotamine tablets:

· Take 2 tablets of caffeine and ergotamine as soon as you announcement headache symptoms, or after an onslaught has already begun.

· If your headache does not completely go away, you may take 1 more tablet after at least 30 minutes have passed.

· If additional medicine is needed, you may take 1 tablet each 30 minutes up to a total of 6 tablets for one migraine attack.

• If you still have migraine symptoms after taking a total of 6 tablets, call your doctor. Do not take more than a total of 6 tablets in any 24-hour period. Do not take more than a total of 10 tablets over a period of 7 days.

• Do not take a rectal suppository by mouth. It is for use only in your rectum.

• Wash your hands till and after inserting the rectal suppository.

• To use caffeine and ergotamine rectal suppositories:

· Insert 1 suppository at the first sign of migraine headache symptoms, or after an onslaught has already begun.

· Remove the wrapper till inserting the suppository. Avoid handling the suppository too long or it will melt in your hands.

· Lie on your back with your knees up toward your chest. Gently insert the suppository into your rectum about 1 inch.

· For excellent results, remain lying down for a little minutes. The suppository will melt quickly and you must feel few or no discomfort while holding it in. Avoid using the bathroom just after using the suppository.

· If your headache does not completely go away, use 1 more suppository after at least 1 hour has passed.

• If you still have migraine symptoms after using a total of 2 rectal suppositories, call your doctor. Do not use more than a total of 2 suppositories for headache. Do not use more than a total of 5 suppositories over a period of 7 days.

• Do not share this medicine with other person, even if they have the same symptoms you have.

• Store at room temperature away from moisture and heat.

What happens if I miss a dose?

• Since caffeine and ergotamine is used only when needed, you are not likely to miss a dose.

• Do not take more than 6 caffeine and ergotamine tablets for day or more than 10 tablets for week.

• Do not use more than 2 suppositories for headache or 5 suppositories for week.

What happens if I overdose?

• Search abnormal medical attention if you think you have used too many of this medication. An overdose of caffeine and ergotamine can be fatal.

What must I avoid while using caffeine and ergotamine?

• Do not use caffeine and ergotamine within 24 hours till or after using other migraine headache medication, including:

· dihydroergotamine, ergonovine, or methylergonovine; or

· almotriptan, eletriptan, frovatriptan, naratriptan, sumatriptan, rizatriptan, or zolmitriptan.

• Grapefruit and grapefruit juice may interact with caffeine and ergotamine and lead to unwanted side effects. Avoid the use of grapefruit commodity while taking caffeine and ergotamine.

What are the possible side effects of caffeine and ergotamine?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

• Stop using caffeine and ergotamine and call your doctor at once if you have:

· weak pulses in your arms and legs, numbness and tingling or pain in your hands or foots, blue-colored fingers or toes;

· painful sores on your rectum after using the rectal suppositories;

· sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;

· quick or slow heart rate;

· leg weakness, muscle pain in your arms or legs;

· severe pain in your stomach or lower back;

· few or no urinating;

· chest discomfort, dry cough or hack, feeling short of breath on exertion; or

· dangerously tall blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

• General side effects may include:

· dizziness, spinning sensation;

· weakness;

· nausea, vomiting; or

· mild itching or swelling.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect caffeine and ergotamine?

• Speak your doctor about all medicines you use, and those you start or stop using during your treatment with caffeine and ergotamine, especially:

· aprepitant;

· cimetidine;

· cyclosporine;

· haloperidol;

· imatinib;

· nicotine;

· an antibiotic--ciprofloxacin, doxycycline, erythromycin, metronidazole, norfloxacin, tetracycline;

· antifungal medication--clotrimazole, fluconazole, voriconazole;

· an antidepressant--desipramine, fluoxetine, fluvoxamine, sertraline;

· diet pills, stimulants, or ADHD medication;

· heart or blood pressure medication--amiodarone, diltiazem, dronedarone, lidocaine, propranolol, verapamil;

· HIV/AIDS medication--atazanavir, fosamprenavir, efavirenz, darunavir when given with ritonavir, saquinavir; or

· medicines to treat asthma, colds or allergies.

• This list is not complete. Another drugs may interact with caffeine and ergotamine, including prescription and over-the-counter medicines, vitamins, and herbal commodity. Not all possible interactions are listed in this medicine manual.

Where can I get more information?

• Your pharmacist can provide more information about caffeine and ergotamine.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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