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Cafergot
Generic Name: ergotamine tartrate and caffeine
Brand name: Cafatine, Cafergot, Cafetrate, Ercaf, Migergot, Wigraine
Indications
This combination medication is used to treat or prevent a certain type of headache (vascular headaches such as migraine headaches and cluster headaches). Ergotamine helps narrow widened blood vessels in the head, which reduces the throbbing effects of vascular headaches. Caffeine increases the effects of ergotamine by increasing the absorption of ergotamine and also by narrowing the widened blood vessels in the head.
Dosage and Administration
Cafergot is available for oral administration as 1 mg/100 mg tablets.
Normal Dosage: For the best results, dosage should start at the first sign of an attack. Adults are recommended to take 2 tablets at the start of attack; 1 additional tablet every 1/2 hour, if needed for full relief (maximum 6 tablets per attack, 10 per week). The maximum dosage for any one attack should not exceed 6 tablets. Total weekly dosage should not exceed 10 tablets.
Overdose?
Overdosage of Cafergot can result in Symptoms of Cafergot overdose include coma, convulsions, diminished or absent pulses, drowsiness, high or low blood pressure, numbness, shock, stupor, tingling, pain and bluish discoloration of the limbs, unresponsiveness, vomiting.
Drug Description
ERGOTAMINE TARTRATE:
Ergotaman-3',6',18-trione, 12'-hydroxy-2'-methyl-5'-(phenyl-methyl)-,(5' α)-, [R-(R*,R*)]-2,3- dihydroxy-butanedioate (2:1) (salt).
CAFFEINE:
1H-Purine-2,6-dione, 3,7-dihydro-1,3,7-trimethylxanthine.
Side effects
The excessive use of Cafergot can lead to ergot poisoning resulting in symptoms such as headache, pain in the legs when walking, muscle pain, numbness, coldness, and abnormal paleness of the fingers and toes. If this condition is not treated, it can lead to gangrene (tissue death due to decreased blood supply).
- Side effects may include:Fluid retention, high blood pressure, itching, nausea, numbness, rapid heart rate, slow heartbeat, tingling or pins and needles, vertigo, vomiting, weakness
- Complications caused by constriction of the blood vessels can be serious.
- They include: Bluish tinge to the skin, chest pain, cold arms and legs, gangrene, muscle pains
Although these symptoms occur most commonly with long-term therapy at relatively high doses, they have been reported with short-term or normal doses. A few people on long-term therapy have developed heart valve problems.
Precautions
- Do not take Cafergot if you have ever had an allergic reaction to ergotamine or caffeine, the active ingredients in Cafergot tablets; any of the other ingredients listed at the end of this leaflet; any other ergot alkaloids (e.g. Ergodryl®, Ergometrine®, Syntometrine®).
- Do not take Cafergot if you have problems with your heart, especially if you have angina that is not controlled or you have had a heart attack; high blood pressure that is not controlled; severe liver or kidney disease; poor blood circulation or other blood vessel disorders (e.g. varicose veins, fluid buildup in legs or feet, or conditions that make your fingers and toes unusually sensitive to cold); a serious infection; you are being treated for HIV/AIDS with a medicine called ritonavir, nelfinavir, indinavir or delavirdine; you are being treated for an infection with a medicine called ketoconazole, itraconazole, erythromycin or clarithromycin
- Do not take Cafergot if you are pregnant or intend to become pregnant.
- Do not breast-feed if you are using Cafergot.
- Do not take Cafergot after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. In such cases, return it to your pharmacist.
- Tell your doctor if you smoke. Nicotine in cigarettes may increase the chance of you having an unwanted side effect called "ergotism" (excessive constriction of blood vessels). See Side Effects section for more information.
- Tell your doctor if you are allergic to any other medicines, foods, dyes or preservatives.Your doctor will want to know if you are prone to allergies.
- Do not take more than six tablets per headache. Do not take more than ten tablets in 7 days. If your symptoms are not being adequately treated, talk to your doctor.
Drug Interactions
Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with caffeine and ergotamine. In rare but severe cases, gangrene or other serious problems can result. The following drugs should not be taken with caffeine and ergotamine or should be used only under the close supervision of a doctor:
- another medication that contains an ergot compound such as Ergomar, D.H.E., or D.H.E. Nasal;
- another migraine headache medicine such as almotriptan (Axert), sumatriptan (Imitrex), zolmitriptan (Zomig), rizatriptan (Maxalt), or naratriptan (Amerge)--these medicines must not be taken within 24 hours of a dose of caffeine and ergotamine;
- a selective serotonin reuptake inhibitor (SSRI) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), sertraline (Zoloft), or paroxetine (Paxil);
- a beta-blocker (which are used to treat high blood pressure, irregular heartbeats, and other heart conditions) such as carteolol (Cartrol), carvedilol (Coreg), labetalol (Normodyne, Trandate), nadolol (Corgard), pindolol (Visken), propranolol (Inderal), sotalol (Betapace), or timolol (Blocadren);
- an HIV/AIDS medicine such as amprenavir (Agenerase), delavirdine (Rescriptor), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), or saquinavir (Invirase, Fortovase);
- the antibiotics erythromycin (Ery-Tab, E.E.S., E-Mycin, Eryc, others) or clarithromycin (Biaxin);
- the antifungals medicines itraconazole (Sporanox) or ketoconazole (Nizoral);
- nefazodone (Serzone);
- cimetidine (Tagamet, Tagamet HB); or
- sibutramine (Meridia).
The use of caffeine and ergotamine may be dangerous if you are taking any of the drugs listed above.
Drugs other than those listed here may also interact with caffeine and ergotamine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.
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