Ergotamine/caffeine

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Ergotamine/caffeine
Combination of
Ergotamine vasoconstrictor, neurotransmitter agonist and antagonist
Caffeine vasoconstrictor, phosphodiesterase inhibitor
Clinical data
Trade names Cafergot, Migergot, others
AHFS/Drugs.com Multum Consumer Information
MedlinePlus a601048
License data
Pregnancy
category
  • AU:C
  • Contraindicated
Routes of
administration 		By mouth, rectal
ATC code
Legal status
Legal status
Identifiers
CAS Number
KEGG

Ergotamine/caffeine, sold under the brand name Cafergot among others, is a fixed-dose combination medication used for the treatment of migraine. It contains ergotamine, as the tartrate, an alpha adrenergic blocking agent; and caffeine, a cranial vasoconstrictor. [3]

Contents

Ergotamine/caffeine is available as a generic medication.

Medical uses

Ergotamine/caffeine is indicated as therapy to abort or prevent vascular headache. [1] [2]

Mechanism of action

Ergotamine binds to 5-HT1B and 5-HT1D receptors. [4] This along with binding to other serotonergic and dopaminergic receptors is their presumed mechanism of action in treating migraine. [4] [5]

Adverse effects

Because the vasoconstrictive effects of ergotamine and caffeine are not selective for the brain, adverse effects due to systemic vasoconstriction can occur. Cold feet or hands, angina pectoris, myocardial infarction, [6] or dizziness are some examples.

It has also been shown to be associated with mitral valve stenosis. [7]

References

  1. 1 2 "Cafergot- ergotamine tartrate and caffeine tablet, film coated". DailyMed. U.S. National Library of Medicine. Archived from the original on 16 January 2014.
  2. 1 2 "Migergot- ergotamine tartrate and caffeine suppository". DailyMed. 29 November 2022. Retrieved 18 May 2024.
  3. ↑ Diener HC, Jansen JP, Reches A, Pascual J, Pitei D, Steiner TJ (2002). "Efficacy, tolerability and safety of oral eletriptan and ergotamine plus caffeine (Cafergot) in the acute treatment of migraine: a multicentre, randomised, double-blind, placebo-controlled comparison". European Neurology. 47 (2): 99–107. doi:10.1159/000047960. PMID   11844898. S2CID   72629130.
  4. 1 2 "Acute treatment of migraine in adults". UpToDate. Wolters Kluwer. 15 January 2018. Retrieved 27 March 2018.
  5. ↑ Fanciullacci M, Granchi G, Sicuteri F (November 1976). "Ergotamine and methysergide as serotonin partial agonists in migraine". Headache. 16 (5): 226–231. doi:10.1111/j.1526-4610.1976.hed1605226.x. PMID   977328. S2CID   45861917.
  6. ↑ Olesen J, Goadsby PJ, Ramadan NM, Tfelt-Hansen P, Michael K, Welch A, eds. (2006). The Headaches (3rd ed.). Lippincott Williams and Wilkins. p. 463. ISBN   978-0781754002.
  7. ↑ Austin SM, el-Hayek A, Comianos M, Tamulonis DJ (October 1993). "Mitral valve disease associated with long-term ergotamine use". Southern Medical Journal. 86 (10): 1179–1181. doi:10.1097/00007611-199310000-00024. PMID   8211344.
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