What Cafergot Is
Cafergot is a trade name of a combined anti-headache drug consisting of ergotamine tartrate and caffeine. It is used alone or in a combination with other drugs to prevent and eliminate certain types of headaches, especially cluster headaches and migraines. These problems are often caused by widening of the blood vessels in the head, which creates hypotension or low blood pressure. Ergotamine and caffeine combination works by narrowing the blood vessels and consequently increasing the pressure. Caffeine also increases the absorption of ergotamine.
Recommendations for Use, Dosage, and Overdose
Cafergot is taken orally and produced in a tablet form. Each pill contains 1 mg ergotamine tartrate, USP, and 100 mg caffeine, USP. Take the drug with or without food as prescribed by your doctor (usually 2 pills at the first sign of a headache followed by 1 pill every half hour until the headache is gone). Do not take more than 6 pills per a headache or 10 pills in a week.
Cafergot is usually taken only as per need. If you were prescribed the medication for a longer-term use (for example, for the prevention of certain types of headaches), take it exactly as per your doctor’s instructions (usually for 2 to 3 weeks).
The dose is based on the type and severity of your headache and response to treatment. When using Cafergot, timing is important. The drug prevents the development of a headache rather than eliminates an established headache. Therefore, the drug should be taken right at the first sign a headache is starting. If you wait longer, when a headache has got more severe, Cafergot may not work as well.
If you are in a risk group for heart problems, your doctor may need to perform a heart exam before treatment. They may even supervise as you take your first dose of the medication in their office to monitor for serious reactions (such as chest pain).
Though the drug helps many, it may also cause addiction sometimes. This risk may be higher if you have a history of substance abuse (such as addiction to drugs or alcohol). Ask your doctor for more details.
If you have to use the drug too often (more than 10 days each month), it may actually worsen the situation and cause medication overuse headache. Do not use the drug more often or for longer than needed. Tell your doctor if your headaches do not go away or if the drug does not work as well, or if your headaches get worse.
If you take Cafergot during a treatment course and accidentally miss a dose, take it as soon as you can. However, if it’s almost time for your next one, skip it. Do not take two doses at a time. If you suspect an overdose, call your healthcare provider or get urgent medical help.
Precautions and Contraindications
You cannot take Cafergot if you are allergic to caffeine, ergotamine or other ergot alkaloids (like dihydroergotamine). Make sure to also tell your doctor about any other allergies you might have. This product may contain additional ingredients that can cause allergic reactions. For more information, ask your doctor or pharmacist.
Before using Cafergot, tell your doctor about your medical history, especially:
- Vasculatory problems (for example, in your extremities or stomach);
- Some types of headaches (basilar or hemiplegic migraine);
- Heart conditions (such as irregular heartbeat, chest pain, previous heart attack);
- Severe kidney or liver disease;
- History of substance abuse;
- Stroke or “mini-stroke” (transient ischemic attack).
Certain diseases can increase your risk for developing heart problems. Tell your doctor if you have any of the following: hypertension (increased blood pressure), diabetes, high cholesterol, family history of cardiac diseases, obesity, age over 45.
Cafergot may influence your awareness, slow down your reaction and make you dizzy. Alcohol or marijuana can worsen these effects. Therefore, it is advised to avoid driving or operating complex machinery for safety reasons. You will also have to abstain from alcohol, marijuana, and other substances that can influence your brain functioning.
Tobacco or other nicotine-containing products can increase the risk of certain side effects such as cardiac conditions and decreased blood flow to the brain or extremities. It is strongly advised to use tobacco while undergoing treatment with Cafergot. Try to quit smoking.
If you need a surgery or certain other medical procedures (like a heart stress test), inform your doctor or another healthcare provider that you take Cafergot or any other drug (including prescription and over-the-counter ones like vitamins or herbal products).
Cafergot is not advised during pregnancy, as it may harm the fetus. Use reliable birth control methods (such as condoms, birth control pills). Tell your doctor right away if you are already pregnant or become pregnant while on Cafergot treatment. It is also not recommended to use Cafergot while breastfeeding. You may need to either use a different anti-headache drug or temporarily discontinue breastfeeding while you’re on Cafergot.
Interactions with Other Drugs and Substances
Certain drug interactions may increase your risk of developing severe side effects or influence each other’s effectiveness. Tell your doctor about all the substances you use (including prescription and over-the-counter drugs, vitamins and herbal products). Do not start, change the dosage or stop any medications without your doctor’s approval.
If you also take anti-migraine drugs of triptan class (like sumatriptan, rizatriptan), you need to make a time interval between them and Cafergot to avoid serious side effects. To know how long exactly you should wait between the doses of these drugs, ask your doctor.
Some other products (such as coffee, energy drinks, coke) may contain caffeine or other substances that can accelerate your heart rate and increase blood pressure. Tell your doctor about the products that you are using (especially diet aids, cough-and-cold drugs, or other headache products).
Cafergot may interfere with certain medical tests (including dipyridamole-thallium imaging tests, urine catecholamine/5-HIAA levels), which can lead to false results. Make sure your doctors and laboratory personnel know you take Cafergot.
In rare cases, Cafergot has caused a serious decrease of blood flow to the extremities or the brain, which can lead to a stroke. The risk increases greatly when Cafergot is taken with other drugs that can inhibit ergotamine clearance. To such drugs belong mifepristone, boceprevir, telithromycin, telaprevir, some antidepressants (like nefazodone), cobicistat, azole antifungals (like itraconazole, ketoconazole), macrolide antibiotics (like erythromycin, clarithromycin, troleandomycin), HIV protease inhibitors (like nelfinavir, ritonavir, indinavir), HIV NNRTIs (like delavirdine), SSRIs (like paroxetine, fluoxetine, fluvoxamine), among others. Make sure not to take these drugs at the same time with Cafergot and inform your doctor or pharmacist if you are taking any of these drugs.
The most common side effects are upset stomach, nausea, vomiting, restlessness, insomnia, and dizziness. If any of these effects linger or get worse, inform your doctor or pharmacist.
Tell your doctor right away if you experience any serious side effects, including:
- Slower, faster or irregular heartbeat;
- Numbness or tingling sensation in fingers or toes;
- Blue nails, toes or fingers;
- Cold hands or feet;
- Fatigue, muscle pain;
- Severe abdominal pain;
- Pain in lower back, insufficient urination, dark urine.
If there are the following severe side effects, seek urgent medical help:
- Pain in the left arm or chest;
- Slurred speech, confusion;
- Blurred vision;
- Weakness on one side of the body.
Grave allergic reactions to Cafergot are rare. However, get urgent medical help if you have noticed any signs of a serious allergic reaction like rash, itching/swelling (especially of the tongue/throat/face), severe dizziness, obstructed breathing.
The list of possible side effects is not complete. If you notice any other reactions, contact your doctor or pharmacist.
Keep in Mind
Provide your doctor with full and accurate information about your medical history, any currently taken drugs, or any special circumstances such as allergies, breastfeeding, pregnancy, etc.
Do not recommend or share your medications with any other person, even if their symptoms are similar to yours.
Keep the pills away from children’s reach. Store them in a dry ventilated place away from sunlight and moisture.
Inform your doctor about any reactions that you experience. If you have any severe side effects, call your doctor immediately!