Sumatriptan Dihydroergotamine

Serotonin syndrome (sibutramine) The rare, but serious, constellation of symptoms also has been reported with the concomitant use of selective serotonin reuptake inhibitors and agents for migraine therapy (eg, sumatriptan, dihydroergotamine), certain opioids (eg, dextromethorphan, meperidine, pentazocine, fentanyl), lithium, or tryptophan. Because sibutramine inhibits serotonin reuptake, it should not be administered with other serotonergic agents. 

Do not use dihydroergotamine, 5-HT- agonists (eg, sumatriptan), ergotamine-containing or ergot-type medications, or methysergide within 24 hours of each other. 

Triptans and dihydroergotamine are drugs of choice for moderate to severe migraine attacks nasal sumatriptan is usually considered the triptan of choice due to its rapid onset there are a number of oral triptans, including frovatriptan, with more favorable biopharmaceuticprofiles and high costs comparisons not available... 

Lesage AS, Wouters R, Van Gompel P, et al. Agonistic properties of alniditan, sumatriptan and dihydroergotamine on human 5-HT1B and 5-HTm receptors... 

Buzzi MG, Moskowitz MA. Evidence for 5-HT1B/1D receptors mediating the antimigraine effect of sumatriptan and dihydroergotamine. Cephalalgia 1991 11 165-168. 

Dihydroergotamine Dihydroergotamine [dye hye droe er GOT a meen], a derivative of ergotamine, is administered intravenously and has an efficacy similar to that of sumatriptan, but nausea is a common adverse effect. 

Administered orally, ergotamine and sumatriptan have only limited bioavailability. Dihydroergotamine may be given by i.m. or slow i.v. injection, sumatriptan subcutaneously, by nasal spray, or as a suppository. When given orally, other triptans such as zolmitriptan, naratriptan, and rizatriptan have higher bioavailability than sumatriptan. 

Pradalier A, Lutz G, Vincent D. Transient global amnesia, migraine, thalamic infarct, dihydroergotamine, and sumatriptan. Headache 2000 40(4) 324-7. 

Clinically important, potentially hazardous interactions with dihydroergotamine, ergotamine, methysergide, oral contraceptives, rizatriptan, sibutramine, St John s wort, sumatriptan, zolmitriptan... 

Clinically important, potentially hazardous interactions with desvenlafaxine, dextromethorphan, dihydroergotamine, ephedra, ergot, fluoxetine, fluvoxamine, isocarboxazid, linezolid, lithium, MAO inhibitors, meperidine, methysergide, naratriptan, nefazodone, paroxetine, phenelzine, rizatriptan, sertraline, sumatriptan, tranylcypromine, tryptophan, venlafaxine, verapamil, zolmitriptan, zuclopenthixol... 

Henry P, d Allens H and the French Migraine Netweik Bordeaux-Lyon-Grenoble Subcutaneous sumatriptan in the acute treatment of migraine in patients using dihydroergotamine as prophylaxis Headache (1993) 33,432-5... 

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