Summary: A 9,10alpha-dihydro derivative of ERGOTAMINE. It is used as a vasoconstrictor, specifically for the therapy of MIGRAINE DISORDERS.

Top Publications

  1. Silberstein S, McCrory D. Ergotamine and dihydroergotamine: history, pharmacology, and efficacy. Headache. 2003;43:144-66 pubmed
    Ergotamine and dihydroergotamine share structural similarities with the adrenergic, dopaminergic, and serotonergic neurotransmitters. As a result, they have wide-ranging effects on the physiologic processes that they mediate...
  2. Ford R, Ford K. Continuous intravenous dihydroergotamine in the treatment of intractable headache. Headache. 1997;37:129-36 pubmed
    We reviewed data on 171 patients with refractory headache treated by continuous intravenous dihydroergotamine mesylate (i.v. DHE 45) and repetitive i.v. DHE and compared the efficacy of continuous i.v. DHE to repetitive i.v. DHE...
  3. Cook R, Shrewsbury S, Ramadan N. Reduced adverse event profile of orally inhaled DHE (MAP0004) vs IV DHE: potential mechanism. Headache. 2009;49:1423-34 pubmed publisher
    MAP0004 is a novel orally inhaled formulation of dihydroergotamine mesylate (DHE) currently in development that has been clinically observed to provide rapid ( approximately 10 minutes) therapeutic levels of DHE but with lower rates of ..
  4. Shrewsbury S, Cook R, Taylor G, Edwards C, Ramadan N. Safety and pharmacokinetics of dihydroergotamine mesylate administered via a Novel (Tempo) inhaler. Headache. 2008;48:355-67 pubmed publisher
    We investigated the pulmonary absorption of dihydroergotamine (DHE) mesylate and compared the safety, pharmacokinetic, and metabolic profile of 4 different doses of orally inhaled DHE delivered by the Tempo Inhaler (MAP Pharmaceuticals ..
  5. Saper J, Silberstein S, Dodick D, Rapoport A. DHE in the pharmacotherapy of migraine: potential for a larger role. Headache. 2006;46 Suppl 4:S212-20 pubmed
    ..b>Dihydroergotamine mesylate (DHE) is a comparatively safe and effective therapy for migraine headache that could potentially be ..
  6. Morren J, Galvez Jimenez N. Where is dihydroergotamine mesylate in the changing landscape of migraine therapy?. Expert Opin Pharmacother. 2010;11:3085-93 pubmed publisher
    ..For many patients with difficult-to-treat migraine, the appropriate use of dihydroergotamine mesylate (DHE) can result in treatment success and unprecedented patient satisfaction...
  7. Aurora S, Silberstein S, Kori S, Tepper S, Borland S, Wang M, et al. MAP0004, orally inhaled DHE: a randomized, controlled study in the acute treatment of migraine. Headache. 2011;51:507-17 pubmed publisher
    ..Injectable dihydroergotamine, although effective, is considered invasive and inconvenient, and intranasal dihydroergotamine is associated ..
  8. Nagy A, Gandhi S, Bhola R, Goadsby P. Intravenous dihydroergotamine for inpatient management of refractory primary headaches. Neurology. 2011;77:1827-32 pubmed publisher
    To determine dosing and side effects of dihydroergotamine as they affect outcomes in primary headache disorders...
  9. Kellerman D, Kori S, Forst A, Chang J, Febbraro S, Wutann L, et al. Lack of drug interaction between the migraine drug MAP0004 (orally inhaled dihydroergotamine) and a CYP3A4 inhibitor in humans. Cephalalgia. 2012;32:150-8 pubmed publisher
    b>Dihydroergotamine (DHE), a proven migraine treatment, currently has product labeling warning against concomitant use of CYP3A4 inhibitors because of potential drug interactions...

More Information


  1. Mather P, Silberstein S, Schulman E, Hopkins M. The treatment of cluster headache with repetitive intravenous dihydroergotamine. Headache. 1991;31:525-32 pubmed
    ..admitted to our headache center 64 tines over the past five years and treated with repetitive intravenous dihydroergotamine (IV DHE)...
  2. Frediani F, Grazzi L, Zanotti A, Mailland F, Zappacosta B, Bussone G. Dihydroergokryptine versus dihydroergotamine in migraine prophylaxis: a double-blind clinical trial. Cephalalgia. 1991;11:117-21 pubmed
    ..The study was controlled vs dihydroergotamine with a double-blind crossover design...
  3. Moubarak A, Rosenkrans C, Johnson Z. Modulation of cytochrome P450 metabolism by ergonovine and dihydroergotamine. Vet Hum Toxicol. 2003;45:6-9 pubmed
    ..modulation of the cytochrome P450 3A (CYP3A4)-mediated metabolism of ergotamine (ET) by ergonovine and dihydroergotamine. Liver microsomes were prepared from rats treated i.p...
  4. Schürks M. Dihydroergotamine: role in the treatment of migraine. Expert Opin Drug Metab Toxicol. 2009;5:1141-8 pubmed publisher
    b>Dihydroergotamine belongs to the oldest migraine-specific drugs. Mainly used by headache experts today, its properties are unfamiliar to many physicians...
  5. Kayser V, Aubel B, Hamon M, Bourgoin S. The antimigraine 5-HT 1B/1D receptor agonists, sumatriptan, zolmitriptan and dihydroergotamine, attenuate pain-related behaviour in a rat model of trigeminal neuropathic pain. Br J Pharmacol. 2002;137:1287-97 pubmed
    ..basis, we have assessed the potential antinociceptive effects of sumatriptan and zolmitriptan, compared to dihydroergotamine (DHE), in a rat model of trigeminal neuropathic pain. 2...
  6. Lipton R. Ergotamine tartrate and dihydroergotamine mesylate: safety profiles. Headache. 1997;37 Suppl 1:S33-41 pubmed
    Ergotamine tartrate (ET) and dihydroergotamine mesylate (DHE) have been widely and effectively used in the treatment of migraine for many decades, although few randomized, controlled clinical trials have been conducted with these ..
  7. Saper J, Silberstein S. Pharmacology of dihydroergotamine and evidence for efficacy and safety in migraine. Headache. 2006;46 Suppl 4:S171-81 pubmed
    b>Dihydroergotamine mesylate (DHE), an ergot alkaloid, has been extensively utilized and studied in the treatment of episodic and chronic migraine...
  8. Nozaki K, Moskowitz M, Boccalini P. CP-93,129, sumatriptan, dihydroergotamine block c-fos expression within rat trigeminal nucleus caudalis caused by chemical stimulation of the meninges. Br J Pharmacol. 1992;106:409-15 pubmed
    ..v.), sumatriptan (720 nmol kg-1 x 2, i.v.) or dihydroergotamine (86 nmol kg-1 x 2, i.v...
  9. Pradalier A, Lanteri Minet M, Geraud G, Allain H, Lucas C, Delgado A. The PROMISE study: PROphylaxis of MIgraine with SEglor (dihydroergotamine mesilate) in French primary care. CNS Drugs. 2004;18:1149-63 pubmed
    Seglor capsules, a unique modified-release formulation of dihydroergotamine mesilate, have long been in clinical use in France for migraine prophylaxis...
  10. Charles J, Jotkowitz S. Observations of the "carry-over effect" following successful termination of chronic migraine in the adolescent with short-term dihydroergotamine, dexamethasone and hydroxyzine: a pilot study. J Headache Pain. 2005;6:51-4 pubmed
    ..The objective was to determine if short-term parenteral dihydroergotamine, dexamethasone and hydroxyzine can terminate chronic migraine and be followed by a continuous respite or ..
  11. Colman I, Brown M, Innes G, Grafstein E, Roberts T, Rowe B. Parenteral dihydroergotamine for acute migraine headache: a systematic review of the literature. Ann Emerg Med. 2005;45:393-401 pubmed
    ..This systematic review is designed to determine the effectiveness of parenteral dihydroergotamine in reducing pain, nausea, and relapse for episodes of acute migraine in adults...
  12. Silberstein S, Young W, Hopkins M, Gebeline Myers C, Bradley K. Dihydroergotamine for early and late treatment of migraine with cutaneous allodynia: an open-label pilot trial. Headache. 2007;47:878-85 pubmed
    To explore whether dihydroergotamine (D.H.E. 45) is equally effective and safe for migraine with allodynia, when administered either early or late in an attack...
  13. Shrewsbury S, Kori S, Miller S, Pedinoff A, Weinstein S. Randomized, double-blind, placebo-controlled study of the safety, tolerability and pharmacokinetics of MAP0004 (orally-inhaled DHE) in adult asthmatics. Curr Med Res Opin. 2008;24:1977-85 pubmed
    MAP0004 (a proprietary formulation of dihydroergotamine mesylate [DHE]) for inhaled delivery is being developed for acute migraine treatment...
  14. Linder S. Treatment of childhood headache with dihydroergotamine mesylate. Headache. 1994;34:578-80 pubmed
    ..patients with migraine without aura who have failed standard outpatient regimens including intravenous dihydroergotamine mesylate (DHE) in conjunction with oral metoclopramide would respond to an inpatient treatment protocol of ..
  15. Scherl E, Wilson J. Comparison of dihydroergotamine with metoclopramide versus meperidine with promethazine in the treatment of acute migraine. Headache. 1995;35:256-9 pubmed
    ..5 mg dihydroergotamine with 10 mg metoclopramide IV...
  16. Edwards K, Norton J, Behnke M. Comparison of intravenous valproate versus intramuscular dihydroergotamine and metoclopramide for acute treatment of migraine headache. Headache. 2001;41:976-80 pubmed
    ..1 and 1.2) compared with intramuscular metoclopramide 10 mg followed 10 minutes later by intramuscular dihydroergotamine 1 mg. Divalproex sodium is approved for prophylaxis of migraine headache...
  17. Aurora S, Rozen T, Kori S, Shrewsbury S. A randomized, double blind, placebo-controlled study of MAP0004 in adult patients with migraine. Headache. 2009;49:826-37 pubmed publisher
    b>Dihydroergotamine mesylate (DHE) is an effective treatment for acute migraine, but its effective use is often limited by the inconvenience and inconsistency of intranasal, intramuscular, or subcutaneous routes of administration...
  18. Schaerlinger B, Hickel P, Etienne N, Guesnier L, Maroteaux L. Agonist actions of dihydroergotamine at 5-HT2B and 5-HT2C receptors and their possible relevance to antimigraine efficacy. Br J Pharmacol. 2003;140:277-84 pubmed
    1. The pharmaceutical compound, dihydroergotamine (DHE) is dispensed to prevent and reduce the occurrence of migraine attacks...
  19. Hoffman L, Mayzell G, Pedan A, Farrell M, Gilbert T. Evaluation of a monthly coverage maximum (drug-specific quantity limit) on the 5-HT1 agonists (triptans) and dihydroergotamine nasal spray. J Manag Care Pharm. 2003;9:335-45 pubmed
    ..milligram coverage maximum (quantity limit) on serotonin 5-HT1 receptor agonists (triptans) and dihydroergotamine (DHE) nasal spray on the utilization and costs of migraine care in an MCO with approximately 600000 covered ..
  20. Magnoux E, Zlotnik G. Outpatient intravenous dihydroergotamine for refractory cluster headache. Headache. 2004;44:249-55 pubmed
    To evaluate the efficacy and safety of outpatient intravenous dihydroergotamine (DHE) for treatment of refractory cluster headache...
  21. Kelley N, Tepper D. Rescue therapy for acute migraine, part 1: triptans, dihydroergotamine, and magnesium. Headache. 2012;52:114-28 pubmed publisher
    To review and analyze published reports on the acute treatment of migraine headache with triptans, dihydroergotamine (DHE), and magnesium in emergency department, urgent care, and headache clinic settings...
  22. Newman Tancredi A, Conte C, Chaput C, Verriele L, Audinot Bouchez V, Lochon S, et al. Agonist activity of antimigraine drugs at recombinant human 5-HT1A receptors: potential implications for prophylactic and acute therapy. Naunyn Schmiedebergs Arch Pharmacol. 1997;355:682-8 pubmed
    ..In contrast, serotonin, dihydroergotamine, sumatriptan, naratriptan and alniditan, which are effective in acute interruption of migraine attacks, each ..
  23. Jourdan G, Verwaerde P, Pathak A, Tran M, Montastruc J, Senard J. In vivo pharmacodynamic interactions between two drugs used in orthostatic hypotension--midodrine and dihydroergotamine. Fundam Clin Pharmacol. 2007;21:45-53 pubmed
    A combination of midodrine and dihydroergotamine (DHE) is frequently used clinically in patients suffering from severe orthostatic hypotension (OH)...
  24. Padon A, Ostadian M, Wright C, Pohl J, Crisp D, Easley D. Dihydroergotamine-associated intestinal ischemia in a child with cyclic vomiting syndrome. J Pediatr Gastroenterol Nutr. 2006;42:573-5 pubmed
  25. Rozen T. Acute therapy for migraine headaches. Semin Neurol. 2006;26:181-7 pubmed
    ..Not every migraineur experiences each phase. Each phase has its own distinct pathogenesis and its own unique acute therapy. The acute therapy for each phase of the migraine attack will be discussed. ..
  26. Jauslin P, Goadsby P, Lance J. The hospital management of severe migrainous headache. Headache. 1991;31:658-60 pubmed
    ..Sumatriptan was not used in patients with chronic daily headaches; in the 8 cases of acute migraine or status migrainosus in which it was used, improvement was rapid and complete in seven. ..
  27. Yamazaki R, Tsuchida K, Otomo S. Effects of dihydroergotamine and etilefrine on experimentally-induced postural hypotension in dogs. J Pharmacobiodyn. 1990;13:519-24 pubmed
    The effects of dihydroergotamine and etilefrine on experimentally-induced postural hypotension were examined. Although dihydroergotamine at 3 and 10 micrograms/kg (i.v...
  28. Villalón C, Centurión D, Willems E, Arulmani U, Saxena P, Valdivia L. 5-HT1B receptors and alpha 2A/2C-adrenoceptors mediate external carotid vasoconstriction to dihydroergotamine. Eur J Pharmacol. 2004;484:287-90 pubmed
    b>Dihydroergotamine produces external carotid vasoconstriction in vagosympathectomized dogs by 5-HT(1B/1D) receptors and alpha(2)-adrenoceptors. This study identified the specific subtypes involved in this response...
  29. Dunzendorfer U, Behm A, Dunzendorfer E, Dunzendorfer A. Drug combinations in the therapy of low response to phosphodiesterase 5 inhibitors in patients with erectile dysfunction. In Vivo. 2002;16:345-8 pubmed
    ..The present study is a clinical follow-up of patients treated with different therapeutical regimens to document the effectiveness of Sildenafil in combination with DHE. ..
  30. Schulman E, Rosenberg S. Claudication: an unusual side effect of DHE administration. Headache. 1991;31:237-9 pubmed
    ..This paper describes pulselessness in two patients during relatively short courses of DHE. Treatment consisted of calcium channel blockers and discontinuation of DHE. Recovery was complete. ..
  31. Queiroz L, Weeks R, Rapoport A, Sheftell F, Baskin S, Siegel S. Early and transient side effects of repetitive intravenous dihydroergotamine. Headache. 1996;36:291-4 pubmed
    Side effects associated with administration of repetitive intravenous dihydroergotamine (DHE) were prospectively studied in 72 patients with chronic daily headache who were hospitalized in a dedicated inpatient headache treatment program...
  32. Bøe M, Monstad P. [Transformed migraine--chronic daily headache]. Tidsskr Nor Laegeforen. 1999;119:4311-3 pubmed
    ..Since 1994, intravenous treatment with dihydroergotamine (DHE) has been used for these patients...
  33. Couet W, Mathieu H, Fourtillan J. Effect of ponsinomycin on the pharmacokinetics of dihydroergotamine administered orally. Fundam Clin Pharmacol. 1991;5:47-52 pubmed
    ..This pharmacokinetic interaction is likely to have clinical consequences and administration of ponsinomycin should be avoided in patients treated orally with DHE. ..
  34. Rothrock J. Patient information regarding subcutaneous self-administration of dihydroergotamine (DHE). Headache. 2007;47:740 pubmed
  35. Warmuth Metz M. [Ergotism of the lower extremities resulting from thrombosis prevention using DHE-heparin. An angiographic follow-up study]. Radiologe. 1988;28:491-3 pubmed
    ..The case was well documented by serial angiography...
  36. Yuan J, Johnson R, Huang R, Wichterman J, Jiang H, Hayton K, et al. Genetic mapping of targets mediating differential chemical phenotypes in Plasmodium falciparum. Nat Chem Biol. 2009;5:765-71 pubmed publisher
    ..Differential sensitivity to dihydroergotamine methanesulfonate (1), a serotonin receptor antagonist, was mapped to a gene encoding the homolog of human P-..
  37. Klapper J, Stanton J. Current emergency treatment of severe migraine headaches. Headache. 1993;33:560-2 pubmed
    To compare the efficacy of the combination of meperidine and hydroxyzine IM, versus dihydroergotamine and metoclopramide IV in the treatment of severe migraine headaches. This was a randomized double-blind, double-dummy study...
  38. Castrucci B, Echegollen Guzmán A, Saraiya M, Smith B, Lewis K, Coughlin S, et al. Cervical cancer screening among women who gave birth in the US-Mexico border region, 2005: the Brownsville-Matamoros Sister City Project for Women's Health. Prev Chronic Dis. 2008;5:A116 pubmed
    ..Because women who are receiving prenatal care have increased interaction with health care providers, Matamoros providers may need to be educated about the need to screen for cervical cancer during this time. ..
  39. Wiesmann W, Peters P, Irskens U, Schwering H. [Diagnosis and therapy of ergotism following the use of heparin-DHE in thrombosis prevention]. Rofo. 1987;147:446-9 pubmed
    Vasospastic complications have been reported in five patients following the use of heparin-dihydroergotamine for thrombo-embolic prophylaxis. The most important diagnostic procedure is angiography, which shows characteristic findings...
  40. Raskin N. Treatment of status migrainosus: the American experience. Headache. 1990;30 Suppl 2:550-3 pubmed
    ..Repeated dosing of dihydroergotamine has proven to be remarkably effective in stabilizing the mechanism of migraine, allowing these patients to ..
  41. Finkel A, Howard J, Mann J. Successful treatment of headache related to intravenous immunoglobulin with antimigraine medications. Headache. 1998;38:317-21 pubmed
    ..Treatment prior to intravenous immunoglobulin with dihydroergotamine mesylate resulted in development of only a mild dull ache without further development of severe head pain...
  42. Pradalier A, Lutz G, Vincent D. Transient global amnesia, migraine, thalamic infarct, dihydroergotamine, and sumatriptan. Headache. 2000;40:324-7 pubmed
    ..Magnetic resonance imaging showed a small lesion with an ischemic appearance in the right thalamus. ..
  43. Akhtar N, Murray M, Rothner A. Status migrainosus in children and adolescents. Semin Pediatr Neurol. 2001;8:27-33 pubmed
    ..Data concerning status migrainosus in children and adolescents is sparse. The varied clinical presentations, diagnostic evaluation, and treatment modalities are discussed. ..
  44. Chen X, Zhong D, Xu H, Schug B, Blume H. Sensitive and specific liquid chromatographic-tandem mass spectrometric assay for dihydroergotamine and its major metabolite in human plasma. J Chromatogr B Analyt Technol Biomed Life Sci. 2002;768:267-75 pubmed
    A sensitive and specific procedure for the simultaneous determination of dihydroergotamine (DHE) and its 8'-hydroxylated metabolite (8'-OH-DHE) in human plasma was developed and validated...
  45. Sánchez de la Nieta M, de la Torre M, Alcazar R, Rivera F. [Acute renal failure caused by dihydroergotamine]. Nefrologia. 2002;22:293 pubmed
  46. Marichal Cancino B, González Hernández A, Manrique Maldonado G, Ruiz Salinas I, Altamirano Espinoza A, Maassenvandenbrink A, et al. Intrathecal dihydroergotamine inhibits capsaicin-induced vasodilatation in the canine external carotid circulation via GR127935- and rauwolscine-sensitive receptors. Eur J Pharmacol. 2012;692:69-77 pubmed publisher
    ..inhibition may prevent this vasodilatation, the present study has investigated the effects of intrathecal dihydroergotamine on the external carotid vasodilatation to capsaicin, ?-CGRP and acetylcholine...
  47. Witting M. Renal papillary necrosis following emergency department treatment of migraine. J Emerg Med. 1996;14:373-6 pubmed
    ..Some of these new medications include parenteral dihydroergotamine (DHE), sumatriptan, and ketorolac...
  48. Looper M, Edrington T, Moubarak A, Callaway T, Rosenkrans C. Effects of the ergot alkaloids dihydroergotamine, ergonovine, and ergotamine on growth of Escherichia coli O157:H7 in vitro. Foodborne Pathog Dis. 2008;5:599-604 pubmed publisher
    A series of experiments were conducted to evaluate the effects of ergot alkaloids (dihydroergotamine, ergonovine, and ergotamine) on E. coli O157:H7 in both pure and mixed ruminal fluid culture. Alkaloids were added to solutions of E...
  49. Cuvellier J, Joriot S, Auvin S, Vallee L. [Pharmacologic treatment of acute migraine attack in children]. Arch Pediatr. 2005;12:316-25 pubmed
    ..In severe migraine attacks, dihydroergotamine mesylate administered orally (20 to 40 microg/kg) or intravenously (maximum 1 mg/day) may be helpful, but ..
  50. Weintraub J. Repetitive dihydroergotamine nasal spray for treatment of refractory headaches: an open-label pilot study. Curr Med Res Opin. 2006;22:2031-6 pubmed
    To evaluate the safety and efficacy of a repetitive intranasal (IN) dihydroergotamine (DHE) burst protocol for treatment of refractory headaches. Patients with refractory headaches were enrolled in a prospective, open-label, pilot study...
  51. Kabbouche M, Linder S. Acute treatment of pediatric headache in the emergency department and inpatient settings. Pediatr Ann. 2005;34:466-71 pubmed
    ..It must be noted that treatments available for use for acute migraine headache in children and adolescents are off-label. Their use is widespread, but double-blind, placebo-controlled studies are still unavailable for this age group. ..
  52. Gil Martínez T, Galiano R. [Transient global amnesia following the use of ergots in the treatment of migraine]. Rev Neurol. 2004;39:929-31 pubmed
    ..We report the cases of two patients with a history of migraines who suffered TGA after taking ergotamine and dihydroergotamine, respectively, to treat an attack of migraine...
  53. Schurks M, Diener H. [Pathophysiology of migraine and clinical implications]. Schmerz. 2008;22:523-6, 528-30 pubmed publisher
    ..Triptans have a peripheral and central mode of action, but they are no longer effective once central sensitization has occurred. ..