Both ergotamines and triptans act as 5HT1B/D serotonin receptor agonists, thereby affecting the neural events leading to neurotransmitter release, to cerebral vasodilatation, and to head pain.
The triptans, like the ergotamines, can cause vasoconstriction (20) and are contraindicated in patients with ischemic heart disease, uncontrolled hypertension, or stroke.
DHE-45 is one of a family of drugs derived from fungal alkaloids, commonly known as ergotamines, which relieve pain by constricting blood vessels in the head.
Although the scientific community that studies heart valve disease is aware of this connection, (see, for example, the chapter by Mayo Clinic physician Margaret Redfield, on "Ergot Alkaloid Heart Disease" in Hurst's textbook "new Types of Cardiovascular disease", published in 1994,) these ergotamine preparations do not adequately warn prescribing doctors and their patients of the true risk of serious heart valve disease and the resulting consequences of treatment that can include open heart surgery and heart valve prostheses.
In terms of the oral therapy segment, we expect that Depomed will fare well with Cambia, as an option for patients who do not like triptans or ergotamines
Some patients continue to take OTC analgesics even though they are inadequate; others may add opioids, ergotamines
, barbiturates, triptans, and benzodiazepines, either borrowed or prescribed (Dowson et al.
Dosing and administration of ergotamine
tartrate and dihydroergotamine.
Norvir must not be taken with Cordarone(R) (amiodarone); ergotamine
, ergonovine, methylergonovine, and dihydroergotamines such as Cafergot(R); Migranal(R); D.