Cafergot

Cafergot is a product of Novartis, which is used to treat vascular headaches, including migraines and cluster headaches. This drug helps narrow the expanded blood vessels in the brain area. Hence helping in lowering vascular headaches. Additionally, the caffeine ingredient in this drug supports the effect of the other component, Ergotamine. The drug is recommended to adults and children by a medical professional. It is recommended to take 2 tablets for adults and 1 for children with increasing dosage if needed. It should not be used to treat usual headaches that may seem different than migraine headaches.

Cafergot 100mg/1mg is a combination medication containing Ergotamine and Caffeine. Ergotamine belongs to a group of drugs known as ergot alkaloids, used primarily to treat migraine-related pain by limiting the blood vessels around the brain. Caffeine, by enhancing the absorption of Ergotamine, helps increase its effectiveness. Together, these ingredients provide significant relief from migraine symptoms by preventing blood vessels from expanding and causing pain. Available in tablet form, the drug comes in the strength of 1 mg of Ergotamine with 100 mg of Caffeine.

It should be taken at the first sign of a migraine headache. Patients are advised to follow their doctor’s advice on dosage to avoid any potential overuse. The medication is suitable for adults as well as children (in critical situations) and can be taken by those for whom other migraine treatments have not been effective. It works by compressing blood vessels and blocking certain receptors in the brain associated with migraine pain.

While effective, the medication can cause side effects, including nausea, vomiting, and dizziness. It is important for patients to consult their healthcare provider if they experience any severe reactions, such as muscle pain. Precautions should be taken by those with certain cardiovascular conditions. In cases of a missed dose, take it as soon as possible, but skip it if it’s near the time for the upcoming dose. For an overdose, immediate medical attention is crucial. Store Cafergot in a cool and dry place away from direct light and out of reach of children.

Cafergot is used to treat vascular headaches such as:

• Migraine
• Cluster headaches
• Histaminic cephalalgia

Strengths and Forms

• Oral Tablet: 1mg/100mg
• Rectal Suppository: 2mg/100mg

Recommended Dosage for Different Patients

• For Adults: Take 2 tablets orally at the first sign of an attack with increasing dosage every half-hour, if needed. Do not cross the maximum dosage of 6 tablets in a day and 10 tablets in a week.
• For Children: 1 tablet at the time of migraine attack with increasing dosage every half-hour if the pain still persists. Do not exceed the limit of maximum doses of 3 tablets in one day and 5 tablets in a week.

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

• Take two tablets at the first sign of a migraine attack.
• Lie down and relax for some time in a quiet and dark room for at least 2 hours.
• If the pain still persists and does not go away within 30 minutes, take more tablets as prescribed by the doctor.
• If the headache continues even after taking maximum dosages in a day, call your medical professional. Do not take more than 6 tablets in one day unless it is consulted by the healthcare provider.
• Depending on the patient, the dosage can vary. Therefore, it is necessary to follow an expert’s advice for effective results.
• Do not chew or crush the tablet. Swallow the medication as a whole.
• Make frequent visits to the doctor to monitor your health progress.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

Cafergot is used mainly to treat migraine headaches with or without aura. The drug is formed by combining two components, namely Ergotamine and Caffeine. The first ingredient works by contracting blood vessels surrounding the brain, thus reducing the headache and other symptoms associated with migraines. The other component, Caffeine, helps to improve the absorption and effectiveness of Ergotamine, making the treatment more efficient. It is crucial for patients to take Cafergot at the beginning of migraine symptoms for better results. This medication is not for routine pain relief and should only be used under the guidance of a healthcare professional due to its serious side effects. It is important to note that this medication is not suitable for general headaches.

Common side effects of Cafergot may include:

• Diarrhea
• Nausea
• Dizziness
• Restlessness
• Upset stomach
• Trouble in sleeping
• Itching
• Dry mouth

Serious side effects of Cafergot may include:

• Swelling on areas like the face, fingers, feet
• Numbness in fingers, toes, or face
• Weakness in the legs
• Anxiety
• Chest pain
• High blood pressure
• Cold hands or feet
• Red or violet blisters on hands or feet
• Change in vision

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

• Rare Circulatory Issues: This drug can occasionally lead to a severe reduction in blood circulation to the arms, hands, feet, or brain, causing a stroke. Immediate medical attention is required if you notice symptoms like chest pain, irregular heartbeat, or severe abdominal pain.
• Increased Risk with Interactions: There are high chances of risks when Cafergot is combined with other drugs that slow down the removal of Ergotamine from your body.
• Caffeine Effects: Since this drug contains Caffeine, excessive consumption of Caffeine from other sources should be avoided as it can increase side effects.
• Allergic Reactions: Do not use this medication if you notice any signs of allergic reactions, like rash, itching, swelling, or trouble breathing.

Boxed Warnings

• Severe Peripheral Ischemia: There is a serious and potentially life-threatening risk of peripheral ischemia when Ergotamine and Caffeine are used together with strong CYP3A4 inhibitors like protease inhibitors and macrolide antibiotics.
• Heightened Levels of Ergotamine and Caffeine: Blocking the CYP3A4 enzyme increases serum levels of Cafergot ingredients, which heightens the risk of vasospasms. This could lead to cerebral ischemia or ischemia of the extremities.

• If you are allergic to these drugs or other ergot alkaloids like dihydroergotamine, tell your pharmacist beforehand, as it contains some inactive ingredients like tartrazine (found in some brands), which are responsible for causing allergic reactions.
• Talk to your doctor if you have any medical history, especially of blood circulation, heart problems, kidney or liver issues.
• Cafergot may cause dizziness, so be cautious while doing any task that requires alertness.
• Both alcohol and marijuana (cannabis) can increase dizziness. Avoid such substances while taking this medication.
• Do not drive or operate machinery until you are confident to perform such activities safely.
• Limit alcoholic drinks as they may also trigger headaches.
• When using this medication, using tobacco products increases the chance of experiencing major side effects, including heart problems and decreased blood circulation to vital organs.
• Avoid smoking or seek medical advice on quitting.
• If you are undergoing any surgery or medical procedures, inform your doctor or dentist about the use of Cafergot.
• Do not use this medication during pregnancy, as it may harm the unborn baby. Discuss effective birth control methods with your medical professional.
• This drug may have an impact on a nursing child since it can dissolve in breast milk. Therefore, be sure to consult with an expert before breastfeeding.

• Potent CYP3A4 Inhibitors: Avoid using Cafergot with strong CYP3A4 inhibitors like ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin, troleandomycin, ketoconazole, and itraconazole due to the risk of acute ergot toxicity (ergotism), which can cause severe vasospasm and ischemia of the extremities, potentially leading to amputation.
• Cerebral Ischemia Risk: Rare cases of cerebral ischemia have occurred when this drug was used with protease inhibitors, sometimes resulting in death.
• Pregnancy: Do not take this medication if you are pregnant, as it may cause fetal harm. The patient should be informed of the possible threats to the fetus if pregnancy occurs while receiving treatment.
• Peripheral Vascular Disease: Patients with this condition should not use Cafergot.
• Coronary Heart Disease: It is contraindicated in patients with heart diseases that affect blood flow to the heart.
• Hypertension: Patients with uncontrolled high blood pressure should avoid taking this medication.
• Impaired Liver or Kidney Function: This drug is contraindicated in patients with significant liver or kidney dysfunction.
• Sepsis: People suffering from sepsis are advised not to take this medication.
• Hypersensitivity: The drug should not be administered to individuals allergic to any of its components.

• Cafergot can be taken as soon as you experience migraine headaches.
• In case you missed a dose of your medication, take it as soon as you feel another headache.
• Do not take double doses at the same time.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

• An overdose of Cafergot may lead to symptoms such as vomiting, numbness, difficulty in breathing, chest pain, muscle pain, stupor, coma, and shock.
• If an overdose occurs, stop taking your medication and start taking appropriate symptomatic treatments to avoid future problems.
• Activated charcoal is also advised in case of overdoses.
• In case of recent intake, gastric lavage is recommended.
• Call a poison control center immediately or seek professional guidance.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

• Keep the medicine in its original container until you take it out for consumption.
• Store in a cool place with a temperature below 77ºF or 25ºC.
• Do not store the medicine in the bathroom or anywhere near the sink.
• Avoid leaving it in the car or on window sills.
• Keep it out of reach from children.
• If you have stopped taking the medication or it has reached its expiration date, dispose of it in an appropriate container.
• Do not flush the medicine.
• Keep the medicine away from heat, moisture, or any direct light.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Not every drug interacting with each other can result in adverse side effects. However, there are certain types that can pose major health risks to different people. Below are some of the list of drug interactions with Cafergot. Therefore, it is important that your healthcare provider know if you are taking any of these medications.

• Vasoconstrictors: Avoid combining Cafergot with other vasoconstrictors such as ergot alkaloids, sumatriptan, other 5HT receptor agonists, and nicotine (from heavy smoking), as this can intensify vasoconstriction.
• Caffeine Metabolism: The interaction of other drugs with Caffeine can increase its plasma concentration, enhancing the absorption of Ergotamine. Additionally, Caffeine is metabolized extensively by CYP1A2, and drugs that affect this enzyme can alter Caffeine’s metabolic clearance.
• Interactions with Sympathomimetics: Combining Caffeine and sympathomimetics may lead to high blood pressure.
• Beta-Blockers: There have been reports of vasospastic disorders when ergotamine-containing drugs are used with beta-blockers like propranolol.
• Moderate/Weak CYP3A4 Inhibitors: Use caution when using Cafergot with weak to moderate CYP3A4 inhibitors like cimetidine, fluconazole, clotrimazole, grapefruit juice, and quinupristin/dalfopristin due to increased exposure to Ergotamine.
• Serotonin Reuptake Inhibitors: Ergotamine should be used cautiously with serotonin reuptake inhibitors (e.g., amitriptyline, sertraline) as there is a risk of serotonin syndrome.
• CYP3A4 Inducers: Drugs that induce CYP3A4 (nevirapine, rifampicin) can decrease the effectiveness of Ergotamine.

[Note: This isn’t a complete list, and there could be other drugs that interact with Cafergot. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

• Sumatriptan
• Imitrex
• Ubrelvy
• Nurtec ODT
• Rizatriptan
• Maxalt
• OnabotulinumtoxinA
• Ubrogepant
• Tizanidine
• Verapamil
• Emgality
• Zanaflex
• Galcanezumab
• Indomethacin

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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