Ergotamine tartrate/dihydroergotamine

Lisuride dihydrogen maleate (h/Jj 30-35), methysergide maleate (h/ij 40-45), dihydroergotamine mesylate (hRf 45-50) and ergotamine tartrate (hRj 70-75) appeared as blue violet chromatogram zones on a yellow background. The detection limits — calculated for free base — were 3-4 ng substance per chromatogram zone. 

Fig. 2 Reflectance scan of a chromatogram track of 90 ng each lysuride hydrogen maleate (1), methysergide maleate (2), dihydroergotamine mesylate (3) and ergotamine tartrate (4) per chromatogram zone.

The effectiveness of dihydroergotamine (DHE) and ergotamine tartrate was demonstrated in old clinical trials which probably would not meet currently accepted criteria for good methodology. For ergotamine tartrate, the dose usually recommended is 1-2 mg/d not to exceed 6 mg/d or 10 mg/week. DHE, which has a low bioavailability, is only effective after parenteral administration (subcutaneous, intramuscular, intravenous, or nasal-spray administration). The recommended dose is 1-2 mg/d. 

Lipton R. Ergotamine tartrate and dihydroergotamine mesylate Safety profiles. Headache 1997 37(suppl 1) S33 1. 

Eight other cases of acute ergotism have been reported "" in which patients were taking ergotamine tartrate or dihydroergotamine and erythromycin. The reaction has been reported to develop within a few hours, but it may take several days to occur. " One case appeared to occur when the erythromycin was started 3 days after the last dose of dihydroergotamine. ... 

There are reports of several other patients who had taken normal doses of ergotamine tartrate or dihydroergotamine for months or years without problems, who then developed severe ergotism within hours or days of starting to take normal doses of troleandomycin. " " This resulted in a myocardial infarction in one patient." ... 

A woman who had previously taken ergotamine tartrate sueeessfully and uneventfully for 16 years was given doxycycline and dihydroergotamine 30 drops three times a day. Five days later her hands and feet be-... 

Fig 2 Reflectance scan of a chromatogram track with 90 ng of each substance per chromatogram zone 1 = lisuride dihydrogen maleate, 2 = methyseigide maleate, 3 = dihydroergotamine mesylate, 4 = ergotamine tartrate. 

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