Cafergot (Caffeine/Ergotamine)

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

• Axert
• Frova
• Maxalt
• Imitrex

Reference:

Cafergot {package insert}. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2002.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/9000s22s23lbl.pdf