1 What is Migranal?

Brand: Migranal

Generic: Dihydroergotamine

Migranal belongs to a group of medications called ergot alkaloids. It is a nasal solution used to help relieve migraine headaches. Nasal Migranal is not an ordinary painkiller. It will not relieve any kind of pain other than throbbing headaches.

Nasal Migranal may cause blood vessels in the body to constrict. This action may lead to serious effects that are caused by a decrease in blood circulation. Discuss the risks and benefits of this medication with your doctor.

This medication is only available with your doctor’s prescription. This medication is available in the following forms:

  • Spray

2 What to Know Before Using

Before using Migranal, you must know all about the risks and complications associated with it. This is a decision that you and your doctor will make together.

For this medication, there are many things that need to be considered:

Allergies: Inform your doctor if you have ever had an allergic reaction to any other medications. It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.

Pediatric: No appropriate studies have been performed on the relationship of age to the effects of this medication in children. Safety and efficacy have not been established.

Geriatric: No appropriate studies have been performed on the relationship of age to the effects of this medication in elderly patients. Safety and efficacy have not been established.

Pregnancy: This medication is listed as Pregnancy Category X. This means that studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant, as they risk obviously outweighs any benefits.

Breastfeeding: Studies have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medication.

Drug Interactions: Certain medications should not be used together. However, in certain cases, two medications may be used together, even if an interaction might occur. In these cases, your doctor may want to change your dose or take other precautions.

When taking this medication, it is important that you inform your doctor if you are taking any of the medications listed below. The following interactions were selected on the basis of potential significance and are not all-inclusive. Using this medication with any of the following is not recommended.

Your doctor may decide not to treat you with this medication, or change some of the other medications you take:

  • Almotriptan
  • Amprenavir
  • Atazanavir
  • Azithromycin
  • Boceprevir
  • Clarithromycin
  • Cobicistat
  • Cocaine
  • Darunavir
  • Delavirdine
  • Dirithromycin
  • Eletriptan
  • Epinephrine
  • Erythromycin
  • Fosamprenavir
  • Frovatriptan
  • Idelalisib
  • Indinavir
  • Itraconazole
  • Josamycin
  • Ketoconazole
  • Lidocaine
  • Lopinavir
  • Mepartricin
  • Midodrine
  • Mifepristone
  • Miokamycin
  • Naratriptan
  • Nefazodone
  • Nelfinavir
  • Norepinephrine
  • Phenylpropanolamine
  • Posaconazole
  • Propylhexedrine
  • Pseudoephedrine
  • Ritonavir
  • Rizatriptan
  • Rokitamycin
  • Roxithromycin
  • Saquinavir
  • Saralasin
  • Spiramycin
  • Sumatriptan
  • Telaprevir
  • Tipranavir
  • Troleandomycin
  • Voriconazole
  • Zolmitriptan

Using this medication with any of the following medication is not recommended, but may be unavoidable in some cases.

Your doctor may make the decision not to treat you with this medication or change some of the other medications you take:

  • Alefacept
  • Blinatumomab
  • Bromocriptine
  • Ceritinib
  • Crizotinib
  • Dabrafenib
  • Dexfenfluramine
  • Enzalutamide
  • Fluconazole
  • Fluvoxamine
  • Golimumab
  • Imatinib
  • Lumacaftor
  • Nilotinib
  • Osimertinib
  • Pazopanib
  • Piperaquine
  • Ranolazine
  • Secukinumab
  • Sibutramine
  • Siltuximab
  • Telithromycin

Using this medication with any of the following medications may increase your risk of side effects. However, using both medications may be the best treatment for you.

If both medications are prescribed together, your doctor may change the dose or how often you take one or both medications:

  • Nitroglycerin
  • Propanolol

Other Interactions: Certain medications should not be used while eating, or while eating certain foods in the case of negative interactions. Using alcohol or tobacco with certain medications may also cause negative interactions. Talk with your doctor about the use of your medication with food, alcohol or tobacco.

Using this medication with any of the following is not normally recommended, but may be unavoidable.

If used together, your doctor may change the dose or how often you take your medication or give you special instructions about the use of food, alcohol or tobacco:

  • Grapefruit juice

Other Medical Problems: Pre-existing medical problems may affect the use of this medication.

Be sure to tell your doctor if you have any other medical problems, especially:

  • Heart or blood vessel disease
  • Hypertension (high blood pressure)
  • Kidney disease
  • Liver disease
  • Infection - The chance of serious side effects caused by nasal dihydroergotamine may be increased. Heart or blood vessel disease and high blood pressure sometimes do not cause any symptoms, so some people do not know that they have these problems. Before deciding whether you should use nasal dihydroergotamine, your doctor may need to do some tests to make sure that you do not have any of these conditions.

3 Proper Usage

Proper usage of Migranal requires strict adherence to your doctor’s orders. Do not take more, less or for a longer or shorter period of time than your doctor tells you.

This medication comes with a patient information brochure. It is very important that your read this information. Ask your doctor if you have any questions.

To relieve your migraine as soon as possible, use this medication as soon as a headache begins. If you get warning signs such as an aura, wait until the pain starts before using this medication. Lying down in a dark and quiet room for a while may help relieve your migraine.

Your doctor may tell you to take another medication to help prevent headaches. It is important to follow your doctor’s directions, even if your headaches continue. Headache-preventing medications may take several weeks to begin working.

Even after they start working, your headaches should occur less often and be less severe and easier to relieve. This can reduce the amount of this medication that you need. If you don’t notice any improvements after several weeks, call your doctor.

Dosing: Different patients will be given a different dose of this medication based on the strength of the medication. The number of doses you take each day, the time between doses and the length of time you take this medication depends on the reason you are taking this medication.

The following information only includes the average dose of this medication. If your dose is different, do not change it without first speaking to your doctor.

  • Adults - One spray in each nostril, then another spray in each nostril 15 minutes after the first dose.
  • Children - Use and dose must be determined by your doctor.

Storage: Store this medication in a closed container at room temperature. Keep it away from heat, moisture, and direct light. Do not freeze.

Keep our of the reach of children. Do not keep expired medication or medication you no longer need. Ask your doctor how to dispose of any medication you do not use.

4 Precautions to Take

In using Migranal, you must be careful and take some precautions as advised by your doctor. Drinking alcoholic beverages may make headaches worse or cause new headaches.

People who suffer from severe headaches should avoid alcoholic drinks, especially during a headache.

This medication may cause some people to become drowsy or less alert than normal. Do not use machinery or do anything else that could be dangerous if you are not alert.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Migranal. Although not all of these side-effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if you experience any of the following side-effects:

Less common or rare:

  • Chest pain
  • Cough, fever, sneezing, or a sore throat
  • Feeling of heaviness in chest
  • Irregular heartbeat (arrhythmia)
  • Itching of the skin
  • Numbness and tingling of face, fingers, or toes
  • Pain in arms, legs, or lower back
  • Pain in back, chest or left arm
  • Pale bluish-colored or cold hands or feet
  • Shortness of breath or troubled breathing
  • Weak or absent pulse in legs

Get emergency help if any of the following symptoms of overdose occur:

Some patients may experience other side effects that are not listed. Check with your doctor if you notice any other side effects. Ask your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.