ERGOTAMINE, BELLADONNA & PHENOBARBITAL

Brand & Generic Names

Bellergal
Bellergal-S
Bellergal Spacetabs

Basic Information

• Habit forming? Yes
• Prescription needed? Yes
• Available as generic? No
• Drug class: Analgesic, antispasmodic, vasoconstrictor

Uses

• Reduces anxiety or nervous tension (low dose).
• Prevents vascular headaches.

Dosage & Usage Information

How to take:
Tablet or extended-release tablet--Swallow with liquid, or let dissolve under tongue.
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. Wait 4 hours for next dose.

What drug does:
Constricts blood vessels in the head.
Blocks nerve impulses at parasympathetic nerve endings, preventing muscle contractions and gland secretions of organs involved.

Time lapse before drug works:
15 to 30 minutes.

Don't take with:
Non-prescription drugs without consulting doctor.

Overdose

SYMPTOMS:
Tingling, cold extremities; muscle pain; nausea; vomiting; diarrhea; cold skin; rapid and weak pulse; severe numbness of extremities; confusion; dilated pupils; rapid pulse and breathing; dizziness; fever; hallucinations; slurred speech; agitation; flushed face; 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:

• Flushed skin, fever, drowsiness, bloating, depression, frequent urination.
• Constipation, dizziness, drowsiness, "hangover" effect, increased frequency or severity of headaches.

Infrequent:

• Swollen feet and ankles, numbness or tingling in hands or feet, cold hands and feet, rash.
• Nasal congestion, altered taste.

Rare:

Jaundice, weak legs, swallowing difficulty, dry mouth, increased sensitivity to sunlight, nausea, vomiting, decreased sweating.

Warnings & Precautions

Don't take if:

• You are allergic to any barbiturate, tartrazine dye, anticholinergic or ergot preparation.
• You have porphyria, trouble with stomach bloating, difficulty emptying your bladder completely, narrow-angle glaucoma, severe ulcerative colitis, enlarged prostate.

Before you start, consult your doctor:

• If you have epilepsy; kidney, thyroid or liver damage; anemia; chronic pain; open-angle glaucoma; angina; fast heartbeat; heart problems; high blood pressure; hardening of the arteries; vein problems; chronic bronchitis; asthma; hiatal hernia; enlarged prostate; myasthenia gravis; peptic ulcer; an infection.
• If you plan to become pregnant within medication period.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

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:

• May cause addiction, anemia, chronic intoxication.
• May lower body temperature, making exposure to cold temperatures hazardous.
• Chronic constipation, possible fecal impaction.
• Cold skin, muscle pain, gangrene of hands and feet. This medicine not intended for uninterrupted use.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

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:
May be unnecessary to finish medicine. Follow doctor's instructions. If you develop withdrawal symptoms of hallucinations, agitation or sleeplessness after discontinuing, call doctor right away.

Others:

• Impaired blood circulation can lead to gangrene in intestines or extremities. Never exceed recommended dose.
• May affect results in some medical tests.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Amantadine	Increased belladonna effect.
Amphetamines*	Dangerous blood pressure rise.
Anticholinergics,	Increased belladonna
other*	effect.
Anticoagulants*,	Decreased anti-
oral	coagulant effect.
Anticonvulsants*	Changed seizure patterns.
Antidepressants,	Decreased anti-
tricyclics (TCA)*	depressant effect. Possible
	dangerous oversedation.
Antidiabetics*,	Increased pheno-
oral	barbital effect.
Antihistamines*	Dangerous sedation. Avoid.
Aspirin	Decreased aspirin effect.
Beta-adrenergic	Narrowed arteries in
blockers*	heart if taken in large doses.
Contraceptives*,	Decreased contraceptive
oral	effect.
Cortisone drugs*	Decreased cortisone effect.
	Increased internal eye pressure.
Digitoxin	Decreased digitoxin effect.
Doxycycline	Decreased doxycycline effect.
Dronabinol	Increased effect of drugs.
Ephedrine	Dangerous blood pressure rise.
Epinephrine	Dangerous blood pressure rise.
Erythromycin	Decreased ergotamine effect.
Griseofulvin	Decreased griseofulvin effect.
Guanethidine	Decreased belladonna effect.
Haloperidol	Increased internal eye pressure.
Indapamide	Increased indapamide effect.
MAO inhibitors*	Increased belladonna and
	phenobarbital effect.
Meperidine	Increased belladonna effect.
Methylphenidate	Increased belladonna effect.
Metoclopramide	May decrease metoclopramide effect.
Mind-altering	Dangerous sedation.
drugs*	Avoid.
Narcotics*	Dangerous sedation. Avoid.
Nitrates*	Increased internal eye pressure.
Nitroglycerin	Decreased nitroglycerin effect.
Orphenadrine	Increased belladonna effect.
Pain relievers*	Dangerous sedation. Avoid.
Phenothiazines*	Increased belladonna effect.
Pilocarpine	Loss of pilocarpine effect in
	glaucoma treatment.
Potassium	Possible intestinal ulcers with
supplements*	oral potassium tablets.
Quinidine	Increased belladonna effect.
Reserpine	Decreased belladonna effect.
Sedatives*	Dangerous sedation. Avoid.
Sleep inducers*	Dangerous sedation. Avoid.
Sumatriptan	Increased vasoconstriction. Delay
	24 hours between drugs.
Tranquilizers*	Dangerous sedation. Avoid.
Troleandomycin	Increased adverse reactions of
	ergotamine.
Valproic acid	Increased phenobarbital effect.
Vitamin C	Decreased belladonna effect. Avoid
	large doses of vitamin C.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Possible fatal oversedation. Avoid.
Beverages:	None expected.
Cocaine:	Excessively rapid heartbeat. Avoid.
Foods:	None expected.
Marijuana:	Drowsiness and dry mouth, excessive
	sedation. Avoid.
Tobacco:	None expected.