Cafergot (Caffeine/Ergotamine)
Medication information written by Dr. Larisa Roybal, PharmD
Updated - January 19, 2021
Cafergot (Ergotamine Tartrate and Caffeine) Medication Information
Uses
Indicated as therapy to abort or prevent vascular headache, e.g., migraine, migraine variants or so-called “histaminic cephalalgia’’.
Dosage
The suppository is available in 2/100 mg tablets
Side Effects
The most common side effects of Cafergot include:
- Headache
- Muscle pains
- Numbness
- Coldness and pallor of the digits
Speak with your doctor or pharmacist for a full list of side effects that applies to you.
Precautions
There have been a few reports of patients on Cafergot therapy developing retroperitoneal and/or pleuropulmonary fibrosis. There have also been rare reports of fibrotic thickening of the aortic, mitral, tricuspid, and/or pulmonary valves with long-term continuous use of Cafergot. Cafergot suppositories should not be used for chronic daily administration.
Rare cases of a solitary rectal or anal ulcer have occurred from abuse of ergotamine suppositories usually in higher than recommended doses or with continual use at the recommended dose for many years. Spontaneous healing occurs within usually 4-8 weeks after drug withdrawal.
Interactions
Some of the common drug interactions with Cafergot:
- Propranolol
- Bupropion
- Clozapine
- Macrolides
- Itraconazole
- Phenytoin
- Protease inhibitors
Speak with your doctor or pharmacist for more information.
Storage
Store at controlled room temperature (77ºF). Protect from moisture.
Pharmacist Tips
- Cafergot should be taken at the first sign of a migraine headache.
- Administration of Cafergot suppositories should not exceed the dosing guidelines and should not be used for chronic daily administration
- Report to your physician immediately any of the following: numbness or tingling in the fingers and toes, muscle pain in the arms and legs, weakness in the legs, pain in the chest or temporary speeding or slowing of the heart rate, swelling or itching.
Cafergot FAQs
How should I use this?
For best results, dosage should start at the first sign of an attack.
Can I take this if I am pregnant?
Cafergot is contraindicated in pregnancy due to the oxytocic effects of ergotamine.
Can I take this while breastfeeding?
Because of the potential for serious adverse reactions in nursing infants from Cafergot, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Can children take this?
Safety and effectiveness in pediatric patients have not been established.
What is the maximal dosage for an attack?
Two suppositories is the maximum dose for an individual attack. Total weekly dosage should not exceed 5 suppositories.
Can I take this to prevent migraines?
In carefully selected patients, with due consideration of maximum dosage recommendations, administration of the drug at bedtime may be an appropriate short-term preventive measure.
Related Drugs
Reference:
Cafergot {package insert}. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2002.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/9000s22s23lbl.pdf
Author: Dr. Larisa Roybal, PharmD
Dr. Roybal is a board-certified pharmacotherapy specialist who has practiced in both ambulatory and acute care settings. Her pharmacy interests include oncology and general inpatient pharmacy.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.