Cafergot oral / rectal

Name: Cafergot oral / rectal

What is Cafergot (caffeine and ergotamine oral/rectal)?

Caffeine is a stimulant that causes narrowing of blood vessels (vasoconstriction).

Ergotamine is in a group of drugs called ergot alkaloids (ER-got AL-ka-loids). It works by narrowing the blood vessels around the brain. Ergotamine also affects blood flow patterns that are associated with certain types of headaches.

Caffeine and ergotamine is a combination medicine used to treat or prevent a migraine type headache.

This medication will only treat a headache that has already begun. It will not prevent migraine headaches or reduce the number of attacks.

Caffeine and ergotamine should not be used to treat common tension headaches or any headache that seems to be different from your usual migraine headaches.

Caffeine and ergotamine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Cafergot (caffeine and ergotamine oral/rectal)?

This medication can harm an unborn baby or cause birth defects. Do not use if you are pregnant.

You should not use caffeine and ergotamine if you have coronary heart disease, high blood pressure, circulation problems, liver or kidney disease, or a serious infection called sepsis.

Some medicines can cause a dangerous decrease in blood flow when used with caffeine and ergotamine. A severe decrease in blood flow to the brain and other parts of the body can lead to dangerous side effects.

Tell your doctor about all medicines you use, and those you start or stop using, especially: atazanavir, boceprevir, clarithromycin, delavirdine, fosamprenavir, imatinib, indinavir, isoniazid, itraconazole, ketoconazole, nefazodone, nelfinavir, nicardipine, posaconazole, quinidine, ritonavir, saquinavir, telaprevir, telithromycin, or voriconazole.

How should I use Cafergot (caffeine and ergotamine oral/rectal)?

Follow all directions on your prescription label. Never use more than your recommended dose. Overuse of migraine headache medicine can make headaches worse. Tell your doctor if the medicine seems to stop working as well in treating your migraine attacks. This medicine is not for daily use.

To use caffeine and ergotamine tablets:

  • Take 2 tablets of caffeine and ergotamine as soon as you notice headache symptoms, or after an attack has already begun.

  • If your headache does not completely go away, you may take 1 more tablet after at least 30 minutes have passed.

  • If additional medication is needed, you may take 1 tablet every 30 minutes up to a total of 6 tablets for one migraine attack.

If you still have migraine symptoms after taking a total of 6 tablets, call your doctor. Do not take more than a total of 6 tablets in any 24-hour period. Do not take more than a total of 10 tablets over a period of 7 days.

Do not take a rectal suppository by mouth. It is for use only in your rectum.

Wash your hands before and after inserting the rectal suppository.

To use caffeine and ergotamine rectal suppositories:

  • Insert 1 suppository at the first sign of migraine headache symptoms, or after an attack has already begun.

  • Remove the wrapper before inserting the suppository. Avoid handling the suppository too long or it will melt in your hands.

  • Lie on your back with your knees up toward your chest. Gently insert the suppository into your rectum about 1 inch.

  • For best results, stay lying down for a few minutes. The suppository will melt quickly and you should feel little or no discomfort while holding it in. Avoid using the bathroom just after using the suppository.

  • If your headache does not completely go away, use 1 more suppository after at least 1 hour has passed.

If you still have migraine symptoms after using a total of 2 rectal suppositories, call your doctor. Do not use more than a total of 2 suppositories per headache. Do not use more than a total of 5 suppositories over a period of 7 days.

Do not share this medication with another person, even if they have the same symptoms you have.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since caffeine and ergotamine is used only when needed, you are not likely to miss a dose.

Do not take more than 6 caffeine and ergotamine tablets per day or more than 10 tablets per week.

Do not use more than 2 suppositories per headache or 5 suppositories per week.

Caffeine / ergotamine Pregnancy Warnings

Caffeine-ergotamine has been assigned to pregnancy category X by the FDA. There are no studies on the placental transfer or teratogenicity of the combined product caffeine-ergotamine. Caffeine has been reported to cross the placenta and to be teratogenic in animals. Ergotamine crosses the placenta in small amounts but has not appeared to be embryotoxic in this quantity. However, prolonged vasoconstriction of the uterine vessels and/or increased myocardial tone leading to reduced myometrial and placental blood flow may have contributed to fetal growth retardation observed in animals. There are no controlled data in human pregnancy. Caffeine-ergotamine use is considered contraindicated during pregnancy.

Caffeine / ergotamine Breastfeeding Warnings

Ergotamine is excreted into human milk. Vomiting, diarrhea and convulsions have been reported in nursing infants. Ergotamine is considered contraindicated during breast-feeding by the American Academy of Pediatrics. Caffeine is excreted into human milk in small amounts. Adverse effects in the nursing infant are unlikely. However, irritability and poor sleep patterns have been reported in nursing infants. The amount of caffeine generally found in caffeinated beverages is considered to usually be compatible with breast-feeding by the American Academy of Pediatrics. Because caffeine is excreted into human milk and because caffeine is metabolized slowly by nursing infants, consumption of more than moderate levels of caffeine by nursing mothers is not recommended.

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