Common uses
Cafergot is used to treat or prevent a certain type of headache (vascular headaches such as migraine headaches and cluster headaches). Ergotamine helps narrow widened blood vessels in the head, which reduces the throbbing effects of vascular headaches. Caffeine increases the effects of ergotamine by increasing the absorption of ergotamine and also by narrowing the widened blood vessels in the head.
Before using
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.
Directions
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.
Cautions
This medication has infrequently caused a lack of blood flow to the hands and feet (peripheral ischemia). It has also rarely caused a lack of blood flow to the brain (cerebral ischemia). The chances of these effects are increased when this medication is taken with certain drugs. Do not take this medication with macrolide antibiotics (e.g., erythromycin, clarithromycin, troleandomycin, telithromycin), protease inhibitors (e.g., amprenavir, indinavir, nelfinavir, ritonavir, saquinavir), or azole antifungals (e.g., ketoconazole, itraconazole, voriconazole). Consult your doctor or pharmacist for more details.
Possible side effects
Nausea, vomiting, upset stomach, restlessness, trouble sleeping, and dizziness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor immediately if any of these unlikely but serious side effects occur: slow/fast/irregular heartbeat, tingling/pain/coldness in the fingers/toes, whitish fingers/toes/nails, loss of feeling in the fingers/toes, bluish hands/feet, muscle pain/weakness, severe stomach/abdominal pain, lower back pain, little or no urine.
Seek immediate medical attention if any of these rare but very serious side effects occur: chest pain, vision changes, confusion, slurred speech.
A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching, swelling, severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
If you take too much
Seek emergency medical attention.
Symptoms of a caffeine and ergotamine overdose include nausea, vomiting, numbness in the fingers or toes, confusion, drowsiness, convulsions.
Additional information
The excessive use of Cafergot can lead to ergot poisoning resulting in symptoms such as headache, pain in the legs when walking, muscle pain, numbness, coldness, and abnormal paleness of the fingers and toes. If this condition is not treated, it can lead to gangrene (tissue death due to decreased blood supply).
Drug interactions
Do not use any of the following migraine drugs within 24 hours of this medicine: almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, or zolmitriptan. Also, do not use this drug with ergotamine (example: Ergomar); dihydroergotamine (DHE or Migranal); methysergide (Sansert); ergonovine; or methylergonovine (Methergine).
Caffeine; ergotamine may also interact with:
•antibiotics such as erythromycin, clarithromycin, and troleandomycin
•antifungal drugs like fluconazole, itraconazole, ketoconazole or voriconazole
•aprepitant
•bromocriptine
•cabergoline
•cocaine
•danazol
•ergoloid mesylates (Hydergine)
•herbal products like feverfew or guarana
•fluoxetine
•fluvoxamine
•grapefruit juice
•imatinib, STI-571
•medicines for colds, flu, or breathing difficulties
•medicines for high blood pressure
•medicines or herbal products to decrease weight or appetite
•metronidazole
•nefazodone
•nicotine
•some medications for the treatment of HIV infection or AIDS
•zileuton
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