Dihydroergotamine Mesylate, Injection

Type of medicine: antimigraine

Generic and brand names: dihydroergotamine mesylate, injection; D.H.E. 45

This medicine is given by injection (shots) to relieve the pain of migraine headaches. This medicine does not work for other types of headaches.

Before taking this medicine, tell your health care provider if you have ever had:

• an allergic reaction to any medicine
• a stroke
• heart disease or a heart attack
• high blood pressure
• kidney or liver problems
• problems with circulation or blood vessel disease
• risk factors for heart disease such as smoking, family history of heart disease, diabetes, or high cholesterol.

Females of childbearing age: Do not use this medicine during pregnancy because it may harm the baby. Be sure to tell your health care provider if you are pregnant. Do not breast-feed while you are using this medicine.

Take this medicine exactly as your health care provider prescribes. Do not take more or take it longer than prescribed. It is not taken on a regular schedule.

The shots are most effective when given at the first sign of a migraine. They can be given into a muscle (IM) or into a large vein (IV).

Do not take more than 6 mL in any 7-day period unless your health care provider specifically tells you to do so. If you are giving yourself these shots, be sure you stay within the dosage limits.

Do not use any other medicine for migraines within 24 hours of using this medicine.

Check with your health care provider if your migraine headaches get worse, or if the medicine does not seem to work as well as it did when you first started using it.

Do not smoke while using this medicine. Smoking may increase your risk of side effects.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

This medicine may make you more sensitive to cold temperatures. Dress warmly during cold weather and avoid prolonged exposure to cold temperatures.

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your health care provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your health care provider right away. If you cannot reach your health care provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your health care provider right away): Numbness and tingling in fingers or toes; muscle pain or weakness in arms or legs; chest pain, irregular heartbeat.

Other: Nausea, vomiting, sweating, flushing, dizziness, drowsiness, soreness where injection was given.

Taking this medicine while you are taking other medicine or can change the way this or any of the other medicines work. Also, using these medicines together might cause harmful side effects. Talk to your health care provider if you are taking any of these medicines:

• alcohol
• antibiotics such as erythromycin (E.E.S), clarithromycin (Biaxin), and metronidazole (Flagyl)
• antifungal medications such as clotrimazole (Mycelex), fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• anti-HIV medicines such as ritonavir (Norvir), amprenavir (Agenerase), and nelfinavir (Viracept)
• antihistamines such as ephedrine, pseudoephedrine (Sudafed), and phenylephrine (Neo-Synephrine)
• beta blockers such as propranolol (Inderal), sotalol (Betapace), and carvedilol (Coreg)
• nicotine in any form (cigarettes, gum, patches, nasal spray)
• other medicines to treat migraine headaches such as sumatriptan (Imitrex) and rizatriptan (Maxalt)
• quinidine
• sibutramine (Meridia)
• SSRI antidepressants such as fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), escitalopram (Lexapro), and sertraline (Zoloft)

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all health care providers who treat you about all the products you are taking.

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your health care provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.