What is dihydroergotamine infusion?
Dihydroergotamine (DHE) infusion is a migraine treatment that works by therapeutically contracting some of the blood vessels that supply the tissues that cover and protect the brain. It also stops the release of natural substances in the brain that contribute to migraine pain.
DHE is a medication in a class of drugs called ergot alkaloids. Infusion therapy involves delivering a medication through an IV, which is done in a hospital setting and requires admission to the facility as a patient. There is also an intramuscular formulation, which is administered in a clinic, and an intranasal formulation, which can be taken at home. DHE cannot be given as a pill.
What is dihydroergotamine infusion used for?
Dihydroergotamine infusion is a treatment for active migraine headaches. It should not be used to prevent migraines. It should not be used more than three times per day and not more than 2-3 times per week unless under close physician supervision. Using DHE too frequently or within 24 hours of a triptan migraine medication can cause constriction of blood vessels in the heart and brain and lead to a stroke or heart attack.
DHE is used to abort a migraine and is good for a migraine that has been going on for more than a few days. It can often break a headache for months. While DHE is not a permanent cure for migraine, symptoms will not necessarily return when the medication wears off.
Am I a good candidate for dihydroergotamine infusion?
You may be a good candidate for dihydroergotamine infusion if you suffer from debilitating migraines that do not respond to other acute treatments.
You should not take DHE if you are talking any of the following medications:
- Antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral)
- HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir)
- Macrolide antibiotics such as clarithromycin (Biaxin), erythromycin (E.E.S., E-Mycin, Erythrocin), and troleandomycin (TAO)
- Triptan migraine medications within 24 hours
You should not use DHE if you suffer from certain heart conditions. Before starting you on DHE, your migraine specialist will conduct a thorough assessment to make sure you can take the medication with minimal risk.
Nausea is the most common side effect of DHE infusion. Your doctor may give you medication to help reduce nausea before beginning the infusion. Other common side effects of DHE include:
- Burning at the site of infusion
- Leg cramps
- Chest pain
- Warmth or pressure in the neck