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Brand name:

Cafergot

Pronounced: KAF-er-got
Generic ingredients: Ergotamine tartrate, Caffeine

Why is this drug prescribed?

Cafergot is prescribed for the relief or prevention of vascular headaches--for example, migraine, migraine variants, or cluster headaches.

Most important fact about this drug

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).

How should you take this medication?

Cafergot is available in both tablet and suppository form. Be sure to take it exactly as prescribed, remaining within the limits of your recommended dosage.

Cafergot works best if you use it at the first sign of a migraine attack. If you get warning signals of a coming migraine, take the drug before the headache actually starts.

Lie down and relax in a quiet, dark room for at least a couple of hours or until you feel better.

Avoid exposure to cold.

To use the suppositories, follow these steps:

1. If the suppository feels too soft, leave it in the refrigerator for about 30 minutes or put it, still wrapped, in ice water until it hardens.
2. Remove the foil wrapper and dip the tip of the suppository in water.
3. Lie down on your side and with a finger insert the suppository into the rectum. Hold it in place for a few moments.

--If you miss a dose...

Take this medication only when threatened with an attack.

--Storage instructions...

Store at room temperature in a tightly closed container away from light. Keep suppositories away from heat.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Cafergot.

• 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.

Why should this drug not be prescribed?

If you are sensitive to or have ever had an allergic reaction to ergotamine tartrate, caffeine, or similar drugs, you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced.

Unless directed to do so by your doctor, do not take this medication if you have coronary heart disease, circulatory problems, high blood pressure, impaired liver or kidney function, or an infection, or if you are pregnant.

Special warnings about this medication

It is extremely important that you do not exceed your recommended dosage, especially when Cafergot is used over long periods. There have been reports of psychological dependence in people who have abused this drug over long periods of time. Discontinuance of the drug may produce withdrawal symptoms such as sudden, severe headaches.

If you experience excessive nausea and vomiting during attacks, making it impossible for you to retain oral medication, your doctor will probably tell you to use rectal suppositories.

This drug is effective only for migraine and migraine-type headaches. Do not use it for any other kind of headache.

Possible food and drug interactions when taking this medication

If Cafergot is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Cafergot with the following:

Beta-blocker drugs (blood pressure medications such as Inderal and Tenormin)
Drugs that constrict the blood vessels, such as EpiPen and the oral decongestant Sudafed
Macrolide antibiotics such as PCE, E.E.S., and Biaxin
Nicotine (Nicoderm, Habitrol, others)

Special information if you are pregnant or breastfeeding

Do not take Cafergot if you are pregnant. Cafergot appears in breast milk and may have serious effects in your baby. If this medication is essential for your health, your doctor may advise you to discontinue breastfeeding.

Recommended dosage

Dosage should start at the first sign of an attack.

ADULTS

Orally

The total dose for any single attack should not exceed 6 tablets.

Rectally

The maximum dose for an individual attack is 2 suppositories.

The total weekly dosage should not exceed 10 tablets or 5 suppositories.

A preventive, short-term dose may be given at bedtime to certain people, but only as prescribed by a doctor.

Overdosage

If you suspect an overdose of Cafergot, seek emergency medical treatment immediately.

• 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