ERGOTAMINE & CAFFEINE

Brand & Generic Names

Cafergot	Ergo-Caff
Cafertine	Gotamine
Cafermine	Migergot
Ercaf	Wigraine

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? No
• Drug class: Analgesic, stimulant (xanthine), vasoconstrictor

Uses

Relieves pain of migraines and other headaches caused by dilated blood vessels. Will not prevent headaches.

Dosage & Usage Information

How to take:
Tablet--Swallow with liquid, or let dissolve under tongue. If you can't swallow whole, crumble tablet and take with liquid or food.
Suppositories--Remove wrapper and moisten suppository with water. Gently insert larger end into rectum. Push well into rectum with finger.
Lie down in quiet, dark room after taking.

When to take:
At first sign of vascular or migraine headache.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Constricts blood vessels in the head.
Constricts blood vessel walls.
Stimulates central nervous system.

Time lapse before drug works:
30 to 60 minutes.

Don't take with:
Non-prescription drugs containing alcohol without consulting doctor.
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Tingling, cold extremities; muscle pain; nausea; vomiting; diarrhea; cold skin; severe numbness of extremities; confusion; excitement; rapid heartbeat; insomnia, hallucinations; convulsions; coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

• Fast heartbeat, feet or ankle swelling.
• Dizziness, nausea, diarrhea, vomiting, nervousness, increased frequency or severity of headaches.

Infrequent:

Itchy skin; abdominal pain; cold hands and feet; weakness in arms, legs, back; confusion; irritability; indigestion; low blood sugar with weakness and trembling.

Rare:

Anxiety; red or purple blisters, especially on hands and feet; change in vision; extreme thirst; numbness or tingling in hands or feet.

Warnings & Precautions

Don't take if:

• You are allergic to any stimulant or any ergot preparation.
• You have heart disease.
• You have active peptic ulcer of stomach or duodenum.

Before you start, consult your doctor:

• If you have irregular heartbeat, angina, heart problems, high blood pressure, hardening of the arteries or vein problems.
• If you have hypoglycemia (low blood sugar), epilepsy, an infection, kidney or liver disease.
• If you are allergic to spray inhalants.
• If you plan to become pregnant within medication period.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons, especially dizziness and excessive potassium loss.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Not recommended.

Prolonged use:
Cold skin, muscle pain, stomach ulcers, gangrene of hands and feet. This medicine not intended for uninterrupted use.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:
Will cause withdrawal symptoms of headache, irritability, drowsiness. Discontinue gradually if you use caffeine for a month or more.

Others:

• May produce or aggravate fibrocystic breast disease in women.
• Impaired blood circulation can lead to gangrene in intestines or extremities. Never exceed recommended dose.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Amphetamines*	Dangerous blood pressure rise.
Beta-adrenergic	Narrowed arteries in
blockers*	heart if taken in large doses.
Cimetidine	Increased caffeine effect.
Contraceptives*,	Increased caffeine
oral	effect.
Ephedrine	Dangerous blood pressure rise.
Epinephrine	Dangerous blood pressure rise.
Erythromycin	Decreased ergotamine effect.
Isoniazid	Increased caffeine effect.
MAO inhibitors*	Dangerous blood pressure rise.
Nitroglycerin	Decreased nitroglycerin effect.
Pseudoephedrine	Dangerous blood pressure rise.
Sedatives*	Decreased sedative effect.
Sleep inducers*	Decreased sedative effect.
Sumatriptan	Increased vasoconstriction. Delay
	24 hours between drugs.
Sympathomimetics*	Overstimulation.
Thyroid hormones*	Increased thyroid effect.
Tranquilizers*	Decreased tranquilizer effect.
Troleandomycin	Increased adverse reactions of
	ergotamine.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Dilates blood vessels. Makes
	headache worse.
Caffeine drinks.	May help relieve headache.
Cocaine:	Overstimulation. Avoid.
Any to which you	May make headache
are allergic.	worse. Avoid.
Marijuana:	Occasional use--Cool extremities.
	Regular use--Persistent chill.
	Increased effect of both drugs. May
	lead to dangerous, rapid heartbeat.
	Avoid.
Tobacco:	Decreased effect of ergotamine and
	caffeine. Makes headache worse.
	Avoid.