Dihydroergotamine tartrate

Details

Stereochemistry	ABSOLUTE
Molecular Formula	2C33H37N5O5.C4H6O6
Molecular Weight	1317.4416
Optical Activity	UNSPECIFIED
Defined Stereocenters	16 / 16
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure Search

SMILES

O[C@H]([C@@H](O)C(O)=O)C(O)=O.CN1C[C@@H](C[C@H]2[C@H]1CC3=CNC4=CC=CC2=C34)C(=O)N[C@]5(C)O[C@@]6(O)[C@@H]7CCCN7C(=O)[C@H](CC8=CC=CC=C8)N6C5=O.CN9C[C@@H](C[C@H]%10[C@H]9CC%11=CNC%12=CC=CC%10=C%11%12)C(=O)N[C@]%13(C)O[C@@]%14(O)[C@@H]%15CCCN%15C(=O)[C@H](CC%16=CC=CC=C%16)N%14C%13=O

InChI

InChIKey=AYYQJUDESMECLY-QCMZQTNXSA-N

InChI=1S/2C33H37N5O5.C4H6O6/c2*1-32(35-29(39)21-15-23-22-10-6-11-24-28(22)20(17-34-24)16-25(23)36(2)18-21)31(41)38-26(14-19-8-4-3-5-9-19)30(40)37-13-7-12-27(37)33(38,42)43-32;5-1(3(7)8)2(6)4(9)10/h2*3-6,8-11,17,21,23,25-27,34,42H,7,12-16,18H2,1-2H3,(H,35,39);1-2,5-6H,(H,7,8)(H,9,10)/t2*21-,23-,25-,26+,27+,32-,33+;1-,2-/m111/s1

HIDE SMILES / InChI

Molecular Formula	C4H6O6
Molecular Weight	150.0868
Charge	0
Count

Stereochemistry	ABSOLUTE
Additional Stereochemistry	No
Defined Stereocenters	2 / 2
E/Z Centers	0
Optical Activity	UNSPECIFIED

Molecular Formula	C33H37N5O5
Molecular Weight	583.6774
Charge	0
Count

Stereochemistry	ABSOLUTE
Additional Stereochemistry	No
Defined Stereocenters	7 / 7
E/Z Centers	0
Optical Activity	UNSPECIFIED

Description
Sources: https://www.ncbi.nlm.nih.gov/pubmed/12558771 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf

Dihydroergotamine (DHE) is a semisynthetic, hydrogenated ergot alkaloid, synthesized by reducing an unsaturated bond in ergotamine. Dihydroergotamine was originally envisaged as an antihypertensive agent, but it was later shown to be highly effective in treating migraine. Dihydroergotamine was first used to treat migraine in 1945 by Horton, Peters, and Blumenthal at the Mayo Clinic. In 1986, Raskin and Callaham reconfirmed the effectiveness of DHE for both intermittent and intractable migraine. The use of DHE was reviewed by Scott in 1992. In 1997, a nasal spray version was approved for use in migraine. Dihydroergotamine is indicated for the acute treatment of migraine headaches with or without aura and the acute treatment of cluster headache episodes. Dihydroergotamine binds with high affinity to 5-HT1Dα and 5-HT1Dβ receptors. It also binds with high affinity to serotonin 5-HT1A, 5-HT2A, and 5-HT2C receptors, noradrenaline α2A, α2B and α, receptors, and dopamine D2L and D3 receptors. The therapeutic activity of dihydroergotamine in migraine is generally attributed to the agonist effect at 5-HT1D receptors. Two current theories have been proposed to explain the efficacy of 5-HT1D receptor agonists in migraine. One theory suggests that activation of 5-HT1D receptors located on intracranial blood vessels, including those on arterio-venous anastomoses, leads to vasoconstriction, which correlates with the relief of migraine headache. The alternative hypothesis suggests that activation of 5-HT1D receptors on sensory nerve endings of the trigeminal system results in the inhibition of proinflammatory neuropeptide release.

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Potency
Serotonin 1d (5-HT1d) receptor 53 Target ID: CHEMBL1983 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/9605573 \| https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2752	0.5 nM [IC50]
Serotonin 1b (5-HT1b) receptor 45 Target ID: CHEMBL1898 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/9605573 \| https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2752	0.7 nM [IC50]
Serotonin 1a (5-HT1a) receptor 177 Target ID: CHEMBL214 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2752	0.4 nM [IC50]
Serotonin 2a (5-HT2a) receptor 237 Target ID: CHEMBL224 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2752	9.0 nM [IC50]
Serotonin 2c (5-HT2c) receptor 131 Target ID: CHEMBL225 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2752	1.3 nM [IC50]
Serotonin 1f (5-HT1f) receptor 15 Target ID: CHEMBL1805 Sources: https://www.ncbi.nlm.nih.gov/pubmed/12558771	Agonist 2752	180.0 nM [IC50]

Conditions

Condition	Modality	Targets	Highest Phase	Product
Migraine 107 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	Primary		Approved 8583	D.H.E. 45 Approved Use Dihydroergotamine Mesylate Injection, USP is indicated for the acute treatment of migraine headaches with or without aura and the acute treatment of cluster headache episodes. Launch Date 1946

C_max

Value	Dose	Co-administered	Analyte	Population
1.02 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8841149/	1 mg single, nasal dose: 1 mg route of administration: Nasal experiment type: SINGLE co-administered:		DIHYDROERGOTAMINE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN

AUC

Value	Dose	Co-administered	Analyte	Population
5.05 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8841149/	1 mg single, nasal dose: 1 mg route of administration: Nasal experiment type: SINGLE co-administered:		DIHYDROERGOTAMINE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN

T_1/2

Value	Dose	Co-administered	Analyte	Population
7.952 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8841149/	1 mg single, nasal dose: 1 mg route of administration: Nasal experiment type: SINGLE co-administered:		DIHYDROERGOTAMINE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN

F_unbound

Value	Dose	Co-administered	Analyte	Population
7% EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/8841149/	1 mg single, nasal dose: 1 mg route of administration: Nasal experiment type: SINGLE co-administered:		DIHYDROERGOTAMINE plasma	Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN

Doses

Dose	Population	Adverse events
2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	Disc. AE: Rhinitis, Dizziness... AEs leading to discontinuation/dose reduction: Rhinitis (2 patients) Dizziness (2 patients) Edema face (1 patient) Cold sweat (1 patient) Trauma (1 patient) Depression (1 patient) Somnolence (1 patient) Allergy (1 patient) Vomiting (1 patient) Hypotension (1 patient) Paraesthesia (1 patient) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
4 mg 1 times / day steady, intranasal Highest studied dose Dose: 4 mg, 1 times / day Route: intranasal Route: steady Dose: 4 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf
1 mg single, subcutaneous Recommended Dose: 1 mg Route: subcutaneous Route: single Dose: 1 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	Disc. AE: Cerebrovascular event... AEs leading to discontinuation/dose reduction: Cerebrovascular event (grade 5) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf
1 mg 1 times / day steady, subcutaneous Recommended Dose: 1 mg, 1 times / day Route: subcutaneous Route: steady Dose: 1 mg, 1 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/	unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/	Disc. AE: Nausea, Vomiting... AEs leading to discontinuation/dose reduction: Nausea (20 patients) Vomiting (3 patients) Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/

AEs

AE	Significance	Dose	Population
Allergy	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Cold sweat	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Depression	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Edema face	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Hypotension	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Paraesthesia	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Somnolence	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Trauma	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Vomiting	1 patient Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Dizziness	2 patients Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Rhinitis	2 patients Disc. AE	2 mg single, intranasal Studied dose Dose: 2 mg Route: intranasal Route: single Dose: 2 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf	unhealthy, 18 - 65 years Health Status: unhealthy Age Group: 18 - 65 years Sex: M+F Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf
Cerebrovascular event	grade 5 Disc. AE	1 mg single, subcutaneous Recommended Dose: 1 mg Route: subcutaneous Route: single Dose: 1 mg Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf	unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/20148s7s8lbl.pdf
Nausea	20 patients Disc. AE	1 mg 1 times / day steady, subcutaneous Recommended Dose: 1 mg, 1 times / day Route: subcutaneous Route: steady Dose: 1 mg, 1 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/	unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/
Vomiting	3 patients Disc. AE	1 mg 1 times / day steady, subcutaneous Recommended Dose: 1 mg, 1 times / day Route: subcutaneous Route: steady Dose: 1 mg, 1 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/	unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: https://pubmed.ncbi.nlm.nih.gov/8984085/

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
substrate 1946

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
P-gp 1741 MATE1 415 MATE2 267 OCT2 779

Drug as perpetrator

Target	Modality	Activity
MATE2 267	inhibitor 4027 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068829/	yes [IC50 12.6 uM]
MATE1 416	inhibitor 4027 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068829/	yes [IC50 2.8 uM]
OCT2 782	inhibitor 4027 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068829/	yes [IC50 49.9 uM]
P-gp 1932	inhibitor 4027 Sources: https://jpet.aspetjournals.org/content/303/1/323.long Page: 5.0	yes [Ki 120 uM]

Drug as victim

Target	Modality	Activity	Metabolite	Clinical evidence
CYP3A4 1946	substrate 4014 Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC152687/	yes

Sourcing

Vendor/Aggregator	ID	URL
ChEBI	CHEBI:4562	https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:4562
ZINC	ZINC000003978005	http://zinc15.docking.org/substances/ZINC000003978005

PubMed

Title	Date	PubMed
Pharmacological characterization of 5-HT(1B) receptor-mediated inhibition of local excitatory synaptic transmission in the CA1 region of rat hippocampus.	2003-01	12522075
Variations among emergency departments in the treatment of benign headache.	2003-01	12514688
Crossover comparison of efficacy and preference for rizatriptan 10 mg versus ergotamine/caffeine in migraine.	2003	12464714
Drug combinations in the therapy of low response to phosphodiesterase 5 inhibitors in patients with erectile dysfunction.	2002-12-24	12494876
Fatal ergotism induced by an HIV protease inhibitor.	2002-12-17	12482227
Management of the acute migraine headache.	2002-12-01	12484694
Valvular heart disease in patients taking pergolide.	2002-12	12479512
Fibrosis due to ergot derivatives: exposure to risk should be weighed up.	2002-12	12472101
The antimigraine 5-HT 1B/1D receptor agonists, sumatriptan, zolmitriptan and dihydroergotamine, attenuate pain-related behaviour in a rat model of trigeminal neuropathic pain.	2002-12	12466238
[Ergotism in a patient treated with ritonavir and ergotamine].	2002-10-26	12421531
Fibrotic valvular heart disease subsequent to bromocriptine treatment.	2002-10-23	12390688
Simplified extraction of ergovaline and peramine for analysis of tissue distribution in endophyte-infected grass tillers.	2002-10-09	12358450
Efficacy and tolerability of prochlorperazine buccal tablets in treatment of acute migraine.	2002-10	12390617
The early use of ergotamine in migraine. Edward Woakes' report of 1868, its theoretical and practical background and its international reception.	2002-10	12383066
Hemicrania continua: a report of ten new cases.	2002-09	12364931
Endocardial myxomatous change in Harlan Sprague-Dawley rats (Hsd:S-D) and CD-1 mice: its microscopic resemblance to drug-induced valvulopathy in humans.	2002-08-22	12187939
[Use and misuse of triptans: a case report].	2002-08-21	12185976
The effect of rizatriptan, ergotamine, and their combination on human peripheral arteries: a double-blind, placebo-controlled, crossover study in normal subjects.	2002-07	12100223
Intravenous valproate sodium in the treatment of daily headache.	2002-06	12167141
Endocrine and respiratory responses to ergotamine in Brahman and Hereford steers.	2002-06	12046966
Buccal absorption of ergotamine tartrate using the bioadhesive tablet system in guinea-pigs.	2002-05-15	11996820
Wilfred Harris' early description of cluster headache.	2002-05	12100097
Incidence and determinants of migraine prophylactic medication in the Netherlands.	2002-05	12012149
Therapeutic strategies for orthostatic intolerance: mechanisms, observations, and making patients feel better.	2002-04-01	11904120
Comparative effects of clonidine and dihydroergotamine on venomotor tone and orthostatic tolerance in patients with severe hypoadrenergic orthostatic hypotension.	2002-04-01	11904110
Frovatriptan: a review of drug-drug interactions.	2002-04	12028322
Specific labelling of serotonin 5-HT(1B) receptors in rat frontal cortex with the novel, phenylpiperazine derivative, [3H]GR125,743. A pharmacological characterization.	2002-04	11888550
Successful treatment of threatening limb loss ischemia of the upper limb caused by ergotamine. A case report and review of the literature.	2002-04	11887064
Comparison of intravenous valproate versus intramuscular dihydroergotamine and metoclopramide for acute treatment of migraine headache.	2002-03-21	11903525
Sensitive and specific liquid chromatographic-tandem mass spectrometric assay for dihydroergotamine and its major metabolite in human plasma.	2002-03-05	11888055
Cardiovascular, respiratory, and body temperature responses of sheep to the ergopeptides ergotamine and ergovaline.	2002-03	11911573
New treatments in cluster headache.	2002-03	11898477
Treatment patterns of isolated benign headache in US emergency departments.	2002-03	11867972
Ergotamine-induced anorectal strictures: report of five cases.	2002-02	11852344
[Critical ischaemia of the limbs and localized livedo in a case of ergotism].	2002-01-25	11807658
[Treatment of migraine in patients with hypertension and ischemic heart disease].	2002-01-20	12122940
[Migraine: a disease, not a symptom].	2002-01-01	11852766
Naratriptan in the prophylaxis of cluster headache.	2002-01	12005276
Syndrome of cerebrospinal fluid hypovolemia following lumbar puncture cerebrospinal fluid leak in a patient with idiopathic intracranial hypertension.	2002-01	11913582
[The problems of migraine headache treatment].	2002	12474651
Postoperative ileus: progress towards effective management.	2002	12466000
An introduction to migraine: from ancient treatment to functional pharmacology and antimigraine therapy.	2002	12434581
[Acute renal failure caused by dihydroergotamine].	2002	12123131
Practical approaches to migraine management.	2002	12027785
Efficacy, tolerability and safety of oral eletriptan and ergotamine plus caffeine (Cafergot) in the acute treatment of migraine: a multicentre, randomised, double-blind, placebo-controlled comparison.	2002	11844898
[Headaches caused by abuse of symptomatic anti-migraine and analgesic treatment].	2001-10	11885515
[Ormond's fibrosis, bone osteolysis and stomach intramural metastases in the course f low-differentiated prostatic cancer].	2001-07	11928571
Management of hot flashes in breast-cancer survivors.	2001-04	11905764
Treatment of childhood headaches.	2001-03	11898510
Ergotamine, dihydroergotamine: current uses and problems.	2001	12463275

Patents

Sample Use Guides

In Vivo Use Guide

Usual Adult Dose for Migraine IM or subcutaneous: Initial dose: 1 mg given as quickly as possible after the first symptom of headache. Additional 1 mg doses can be given hourly until the headache has stopped or a total dose of 3 mg has been reached. The total weekly dose should not exceed 6 mg. IV: Initial dose: 1 mg given as quickly as possible after the first symptom of headache. Additional 1 mg doses can be given hourly until the headache has stopped or a total dose of 2 mg has been reached. The total weekly dose should not exceed 6 mg. Intranasal: 1 spray (0.5 mg) into each nostril (total = 1 mg). Repeat if needed within 15 minutes to a maximum of 4 sprays (2 mg) per day. The total weekly dose should not exceed 8 sprays (4 mg). Usual Adult Dose for Cluster Headache IM or subcutaneous: Initial dose: 1 mg given as quickly as possible after the first symptom of headache. Additional 1 mg doses can be given hourly until the headache has stopped or a total dose of 3 mg has been reached. The total weekly dose should not exceed 6 mg. IV: Initial dose: 1 mg given as quickly as possible after the first symptom of headache. Additional 1 mg doses can be given hourly until the headache has stopped or a total dose of 2 mg has been reached. The total weekly dose should not exceed 6 mg.

Route of Administration: Other

In Vitro Use Guide

Dihydroergotamine (DHE) (EC(50)=10.9+/-0.3 nM) and 8'-OH-DHE (EC(50)=30.4+/-0.8 nM) inhibited the firing of serotoninergic neurons in the rat dorsal raphe nucleus within brain stem slices.

Substance Class	Chemical Created by `admin` on `Mon Mar 31 19:17:18 GMT 2025` Edited by `admin` on `Mon Mar 31 19:17:18 GMT 2025`
Record UNII	76F2R89O7X
Record Status	`Validated (UNII)`
Record Version

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Name

Type

Language

Dihydroergotamine tartrate

Common Name

English

Dihydroergotamine tartrate [WHO-DD]

Preferred Name

English

Ergotaman-3?,6?,18-trione, 9,10-dihydro-12?-hydroxy-2?-methyl-5?-(phenylmethyl)-, (5??,10?)-, (2R,3R)-2,3-dihydroxybutanedioate (2:1) (salt)

Systematic Name

English

Ergotaman-3?,6?,18-trione, 9,10-dihydro-12?-hydroxy-2?-methyl-5?-(phenylmethyl)-, (5??,10?)-, (2R,3R)-2,3-dihydroxybutanedioate (2:1)

Systematic Name

English

Code System Code Type Description

FDA UNII

76F2R89O7X