Last update: May 7, 2019

Dihydroergotamine

Decreased level of risk

New scientific evidences have driven the Apilam staff to update the level of risk associated to this product.
Former level of risk, which was High Risk probable, is now set to Low Risk probable.

Level of risk reviewed on May 7, 2019

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Ergot derivative alkaloid. It may inhibit prolactin secretion.

It is used together with other substances (e.g. caffeine, which is a cause of anxiety). Multiple drug association is not recommended.

On latest update relevant data on breastfeeding was not found.

Sumatriptan which is a drug with well known low excretion into breast milk should be an alternative treatment for Migraine.


See below the information of this related product:

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Group

Dihydroergotamine belongs to this group or family:

Tradenames

Main tradenames from several countries containing Dihydroergotamine in its composition:

Pharmacokinetics

Variable Value Unit
Bioavailability 6 - 8 %
Molecular weight 584 daltons
Protein Binding 90 - 95 %
VD 11 - 30 l/Kg
Tmax 0,25 - 2 hours
T1/2 9 - 32 hours

References

  1. Bordini CA, Roesler C, Carvalho Dde S, Macedo DD, Piovesan É, Melhado EM, Dach F, Kowacs F, Silva Júnior HM, Souza JA, Maciel JA Jr, Carvalho JJ, Speciali JG, Barea LM, Queiroz LP, Ciciarelli MC, Valença MM, Lima MM, Vincent MB. Recommendations for the treatment of migraine attacks - a Brazilian consensus. Arq Neuropsiquiatr. 2016 Abstract Full text (link to original source) Full text (in our servers)
  2. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014 Abstract
  3. AEMPS - Mizar. Dihidroergotamina (Tonopan). Ficha técnica. 2014 Full text (in our servers)
  4. Worthington I, Pringsheim T, Gawel MJ, Gladstone J, Cooper P, Dilli E, Aube M, Leroux E, Becker WJ; Canadian Headache Society Acute Migraine Treatment Guideline Development Group.. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013 Sep;40(5 Suppl 3):S1-S80. Review. Abstract
  5. Duong S, Bozzo P, Nordeng H, Einarson A. Safety of triptans for migraine headaches during pregnancy and breastfeeding. Can Fam Physician. 2010 Abstract Full text (link to original source) Full text (in our servers)
  6. Jürgens TP, Schaefer C, May A. Treatment of cluster headache in pregnancy and lactation. Cephalalgia. 2009 Abstract
  7. FDA-Draxis Dihydroergotamine (DHE 45). Drug Summary. 2008 Full text (in our servers)
  8. MacGregor EA. Migraine in pregnancy and lactation: a clinical review. J Fam Plann Reprod Health Care. 2007 Abstract Full text (in our servers)
  9. Loder E. Migraine in pregnancy. Semin Neurol. 2007 Abstract
  10. Moretti ME, Lee A, Ito S. Which drugs are contraindicated during breastfeeding? Practice guidelines. Can Fam Physician. 2000 Sep;46:1753-7. Review. Abstract Full text (link to original source) Full text (in our servers)
  11. Wojnar-Horton RE, Hackett LP, Yapp P, Dusci LJ, Paech M, Ilett KF. Distribution and excretion of sumatriptan in human milk. Br J Clin Pharmacol. 1996 Abstract Full text (link to original source) Full text (in our servers)
  12. Danjou P, Lacomblez L, Warot D, Puech AJ. Effects of dihydroergotamine on psychomotor function, neuroendocrine parameters and blood pressure, in healthy volunteers. Int Clin Psychopharmacol. 1989 Jan;4(1):71-83. Abstract

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