$Unique_ID{BRK01946}
$Pretitle{}
$Title{ERGOTAMINE AND CAFFEINE COMBINATION}
$Subject{Cafergot (Sandoz)
Cafetrate (Schein)
Ercatab (Parmed)
Ergo Caff (Rugby)
Wigraine (Organon)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


ERGOTAMINE AND CAFFEINE COMBINATION
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BRAND NAMES (Manufacturers):
     Cafergot (Sandoz)
     Cafetrate (Schein)
     Ercatab (Parmed)
     Ergo Caff (Rugby)
     Wigraine (Organon)
TYPE OF DRUG:
     Antimigraine (vasoconstrictor)
INGREDIENTS:
     ergotamine and caffeine
DOSAGE FORMS:
     Tablets (1 mg ergotamine, 100 mg caffeine)
     Suppositories (2 mg ergotamine, 100 mg caffeine)
STORAGE:
     Ergotamine and caffeine combination tablets should be stored at room
       temperature in tightly closed, light-resistant containers.  They should
       also be stored away from heat and direct sunlight.
     The suppository form of this medication should be stored in the
       refrigerator (never frozen) in a tightly closed container.

USES

     This medication is used to treat migraine and cluster headaches.  These
headaches are thought to be caused by an increase in the diameter of the blood
vessels in the head, which results in increased blood flow, increased
pressure, and pain.  Ergotamine is a vasoconstrictor:  it acts by constricting
(narrowing) the blood vessels.  Caffeine helps in both the absorption of the
drug from the gastrointestinal tract and in constricting blood vessels.

TREATMENT

     It is best to take this medication as soon as you notice your migraine
headache symptoms.  If you wait until the headache becomes severe, the drug
takes longer to work and may not be as effective.
     After you take either of these forms of ergotamine and caffeine
combination, you should try to lie down in a quiet, dark room for at least two
hours (in order to help the medication work).  The drug usually takes effect
within 30 to 60 minutes.
     It is very important that you understand how often you can repeat a dose
of this medication during an attack (usually every 30 to 60 minutes) and the
maximum number of tablets you can take per day (usually six tablets).  Ten is
generally the maximum number of tablets that can be taken in any one-week
period.  CHECK WITH YOUR DOCTOR if you have any questions.
     The tablets should be swallowed with liquid.  Take one tablet when you
first notice your migraine headache symptoms.  If necessary, take a second
dose 30 to 60 minutes later to relieve your headache.
     To use the suppository form of this medication, first unwrap it and
moisten it slightly with water (if the suppository is too soft to insert, run
cold water over it or refrigerate it for 30 minutes before you unwrap it).
Lie down on your left side, with your right knee bent.  Push the suppository
well into the rectum with your finger.  Try to avoid having a bowel movement
for at least an hour to give the medication time to be absorbed.  Insert one
suppository when you first notice your migraine symptoms.  If necessary,
insert a second suppository one hour later for full relief of your migraine
headache.
     If you are on prolonged treatment with this drug and you miss a dose,
take it as soon as you remember.  Wait four hours to take the next dose.  It
is very important that you consult your doctor before you discontinue using
this drug.  Your doctor may want to reduce your dosage gradually.

SIDE EFFECTS

     Minor.

     Diarrhea, dizziness, headache, nausea, nervousness or jitters, vomiting,
or sensation of cold hands and feet with MILD numbness or tingling.  These
side effects should disappear as your body adjusts to the medication.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
chest pain; coldness, numbness, pain, tingling, or dark discoloration of the
fingers or toes; confusion; fluid retention; itching; localized swelling;
muscle pain; severe abdominal pain and swelling; severe nausea or vomiting; or
unusual weakness.

INTERACTIONS

     Ergotamine and caffeine combination interacts with several other types of
medications:
     1. Ergotamine interacts with amphetamines, ephedrine, epinephrine
(adrenaline), pseudoephedrine, erythromycin, and troleandomycin.  Such
combinations can lead to increases in blood pressure or increased risk of
adverse reaction to ergotamine.
     2. Do not drink alcoholic beverages while you are taking this medication.
Since alcohol dilates (widens) the blood vessels, drinking will only make your
headache worse.
     3. Ergotamine interacts with marijuana to produce cold sensations in the
arms and legs or even persistent chill.
     4. Tobacco (nicotine) and cocaine decrease the effectiveness of
ergotamine and, therefore, make the headache worse.
     5. The caffeine in tea, coffee, and cola drinks also interacts with this
medication.
     BE SURE TO TELL YOUR DOCTOR about any medications or substances you are
currently taking or using, especially any of those listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
medications, especially to ergotamine, caffeine, or any ergot alkaloid
(ergonovine, ergoloid mesylates, bromocriptine).
     * Before starting to take this medication, be sure to tell your doctor if
you now have or if you have ever had heart or blood vessel disease, high blood
pressure, infections, kidney disease, liver disease, or thyroid disease.
     * Avoid any foods to which you are allergic--they may make your headache
worse.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous equipment.
     * Try to avoid exposure to cold.  Since this drug acts by constricting
blood vessels throughout the body (not just in the head), your fingers and
toes may become especially sensitive to the cold.
     * Elderly patients are more sensitive to the effects of ergotamine.
Consult your doctor if the side effects become bothersome.
     * This medication should not be taken for longer periods or in higher
doses than recommended by your doctor.  Extended use of this drug can lead to
serious side effects.  In addition, tolerance can develop--higher doses would
be required to obtain the same beneficial effects (at the same time increasing
the risk of side effects).
     * Be sure to tell your doctor if you are pregnant.  This medication can
cause contractions of the uterus, which can harm the developing fetus.  This
drug should not be used during pregnancy.  Also, tell your doctor if you are
breast-feeding an infant.  Ergotamine and caffeine combination passes into
breast milk and may cause vomiting, diarrhea, irritability, or convulsions in
the nursing infant.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
