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All about: Cafergot

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Generic Name: caffeine and ergotamine (cah FEEN and er GOH tah meen)
Brand Names: Cafatine, Cafergot, Cafetrate, Ercaf, Migergot, Wigraine

What is Cafergot (caffeine and ergotamine)?

Caffeine and ergotamine both cause vasoconstriction (narrowing) of arteries and veins that supply blood to the head.

Caffeine and ergotamine is used to prevent and to treat vascular headaches such as migraine and migraine-like headaches.

Caffeine and ergotamine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Cafergot (caffeine and ergotamine)?

Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with caffeine and ergotamine. In rare but severe cases, gangrene or other serious problems can result. Some, but not all, of these medications are listed below in the section "What other drugs will affect caffeine and ergotamine?". Do not take any other medications during treatment with caffeine and ergotamine without first talking to your doctor. Contact your doctor immediately if you experience numbness or tingling in the fingers or toes, chest pain, weakness of the legs, muscle pain in the arms or legs, pain in the chest, changes in heart rate, swelling or itching. Do not take caffeine and ergotamine if you are pregnant or if you could become pregnant during treatment. Caffeine and ergotamine is in the FDA pregnancy category X. This means that caffeine and ergotamine can cause harm to an unborn baby. Caffeine and ergotamine can induce uterine contractions, which can result in abortion, and it can restrict blood flow to the fetus.

Do not use more than six tablets or two suppositories per headache. Do not use more than ten tablets or five suppositories in seven days. If your symptoms are not being adequately treated, talk to your doctor.

What should I discuss with my healthcare provider before taking caffeine and ergotamine ?

Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with caffeine and ergotamine. In rare but severe cases, gangrene or other serious problems can result. Some, but not all, of these medications are listed below in the section "What other drugs will affect caffeine and ergotamine?". Do not take any other medications during treatment with caffeine and ergotamine without first talking to your doctor. Do not take caffeine and ergotamine without first talking to your doctor if you have:
  • peripheral vascular disease or poor circulation;

  • arteriosclerosis or "hardening of the arteries";

  • high blood pressure;

  • heart disease;

  • liver disease;
  • kidney disease; or
  • a serious infection.

You may not be able to take caffeine and ergotamine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Do not take caffeine and ergotamine if you are pregnant or if you could become pregnant during treatment. Caffeine and ergotamine is in the FDA pregnancy category X. This means that caffeine and ergotamine can cause harm to an unborn baby. Caffeine and ergotamine can induce uterine contractions, which can result in abortion, and it can restrict blood flow to the fetus. Caffeine and ergotamine may pass into breast milk and harm a nursing infant. Do not take caffeine and ergotamine without first talking to your doctor if you are breast-feeding a baby.

How should I take Cafergot (caffeine and ergotamine)?

Take caffeine and ergotamine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take caffeine and ergotamine at the first sign of an attack.

For the oral tablets, two tablets should be taken at the first sign of a vascular headache; followed by one additional tablet every half hour if needed, up to six tablets per attack.

Use the rectal suppositories as directed by your doctor. One suppository should be administered at the first sign of a vascular headache; followed by one additional suppository after one hour if needed, up to two suppositories per attack.

Do not use more than six tablets or two suppositories per headache. Do not use more than ten tablets or five suppositories in seven days. If your symptoms are not being adequately treated, talk to your doctor.

Store caffeine and ergotamine at room temperature away from moisture and heat.

What happens if I miss a dose?

Since caffeine and ergotamine is taken on an as-needed basis, missing a dose is not usually a problem.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a caffeine and ergotamine overdose include nausea, vomiting, numbness in the fingers or toes, confusion, drowsiness, convulsions, and possibly death.

What should I avoid while taking Cafergot (caffeine and ergotamine)?

Do not take more than six tablets per headache. Do not take more than ten tablets in 7 days. If your symptoms are not being adequately treated, talk to your doctor.

Cafergot (caffeine and ergotamine) side effects

Stop taking caffeine and ergotamine and seek emergency medical attention or contact your doctor immediately if you experience.
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

  • chest pain;

  • numbness or tingling in the fingers or toes;

  • muscle pain in the arms or legs;

  • leg weakness;

  • changes in heart rate;

  • swelling; or

  • itching.

Other, less serious side effects may also occur. Continue to take caffeine and ergotamine and talk to your doctor if you experience nausea or vomiting.

Caffeine and ergotamine may be habit forming when used for long periods of time. Larger doses may be needed for headache relief, and withdrawal effects may occur when caffeine and ergotamine therapy is stopped.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Cafergot (caffeine and ergotamine)?

Some medications may increase the risk of dangerously decreased blood flow to the brain, heart, or extremities when taken with caffeine and ergotamine. In rare but severe cases, gangrene or other serious problems can result. The following drugs should not be taken with caffeine and ergotamine or should be used only under the close supervision of a doctor:
  • another medication that contains an ergot compound such as Ergomar, D.H.E., or D.H.E. Nasal;

  • another migraine headache medicine such as almotriptan (Axert), sumatriptan (Imitrex), zolmitriptan (Zomig), rizatriptan (Maxalt), or naratriptan (Amerge)--these medicines must not be taken within 24 hours of a dose of caffeine and ergotamine;

  • a selective serotonin reuptake inhibitor (SSRI) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), sertraline (Zoloft), or paroxetine (Paxil);

  • a beta-blocker (which are used to treat high blood pressure, irregular heartbeats, and other heart conditions) such as carteolol (Cartrol), carvedilol (Coreg), labetalol (Normodyne, Trandate), nadolol (Corgard), pindolol (Visken), propranolol (Inderal), sotalol (Betapace), or timolol (Blocadren);

  • an HIV/AIDS medicine such as amprenavir (Agenerase), delavirdine (Rescriptor), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), or saquinavir (Invirase, Fortovase);

  • the antibiotics erythromycin (Ery-Tab, E.E.S., E-Mycin, Eryc, others) or clarithromycin (Biaxin);

  • the antifungals medicines itraconazole (Sporanox) or ketoconazole (Nizoral);

  • nefazodone (Serzone);

  • cimetidine (Tagamet, Tagamet HB); or

  • sibutramine (Meridia).

The use of caffeine and ergotamine may be dangerous if you are taking any of the drugs listed above.

Drugs other than those listed here may also interact with caffeine and ergotamine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

  • Your pharmacist has more information about caffeine and ergotamine written for health professionals that you may read.

What does my medication look like?

Caffeine and ergotamine is available with a prescription under several brand and generic names in tablet and rectal suppository formulations. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 2.03. Revision Date: 2/13/04 4:06:52 PM.

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