Migranal Nasal Spray (Dihydroergotamine Mesylate)
Migranal Nasal Spray (℞)
4mg/ml Spray, Metered Dose
(℞) Prescription required. Product of Canada. Shipped from Canada.
To comply with Canadian International Pharmacy Association regulations you are permitted to order a 3-month supply or the closest package size available based on your personal prescription. read more
Dihydroergotamine Mesylate Information
(dye hye droe er got' a meen)Do not take dihydroergotamine if you are taking any of the following medications: antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir); or macrolide antibiotics such as clarithromycin (Biaxin), erythromycin (E.E.S., E-Mycin, Erythrocin), and troleandomycin (TAO).
- Check your ampule to be sure it is safe to use. Do not use the ampule if it is broken, cracked, labeled with an expiration date that has passed, or contains a colored, cloudy, or particle-filled liquid. Return that ampule to the pharmacy and use a different ampule.
- Wash your hands well with soap and water.
- Check to be sure all the liquid is at the bottom of ampule. If any liquid is at the top of the ampule, gently flick it with your finger until it falls to the bottom.
- Hold the bottom of the ampule in one hand. Hold the top of the ampule between the thumb and pointer of your other hand. Your thumb should be over the dot on the top of the ampule. Push the top of the ampule backward with your thumb until it breaks off.
- Tilt the ampule at a 45-degree angle and insert the needle into the ampule.
- Pull back the plunger slowly and steadily until the top of the plunger is even with the dose your doctor told you to inject.
- Hold the syringe with the needle pointing upward and check if it contains air bubbles. If the syringe does contain air bubbles, tap it with your finger until the bubbles rise to the top. Then slowly push the plunger up until you see a drop of medication at the tip of the needle.
- Check the syringe to be sure it contains the correct dose, especially if you had to remove air bubbles. If the syringe does not contain the correct dose, repeat steps 5 to 7.
- Choose a spot to inject the medication on either thigh, well above the knee. Wipe the area with an alcohol swab using a firm, circular motion, and allow it to dry.
- Hold the syringe with one hand and hold a fold of skin around the injection site with the other hand. Push the needle all the way into the skin at a 45- to 90-degree angle.
- Keep the needle inside the skin, and pull back slightly on the plunger.
- If blood appears in the syringe, pull the needle slightly out of the skin and repeat step 11.
- Push the plunger all the way down to inject the medication.
- Pull the needle quickly out of the skin at the same angle you inserted it.
- Press a new alcohol pad on the injection site and rub it.
- Check your ampule to be sure it is safe to use. Do not use the ampule if it is broken, cracked, labeled with an expiration date that has passed, or contains a colored, cloudy, or particle filled liquid. Return that ampule to the pharmacy and use a different ampule.
- Check to be sure all the liquid is at the bottom of the ampule. If any liquid is at the top of the ampule, gently flick it with your finger until it falls to the bottom.
- Place the ampule straight and upright in the well of the assembly case. The breaker cap should still be on and should be pointing up.
- Push down the lid of the assembly case slowly but firmly until you hear the ampule snap open.
- Open the assembly case, but do not remove the ampule from the well.
- Hold the nasal sprayer by the metal ring with the cap pointing up. Press it onto the ampule until it clicks. Check the bottom of the sprayer to be sure the ampule is straight. If it is not straight, push it gently with your finger.
- Remove the nasal sprayer from the well and remove the cap from the sprayer. Be careful not to touch the tip of the sprayer.
- To prime the pump, point the sprayer away from your face and pump it four times. Some medication will spray in the air, but a full dose of medication will remain in the sprayer.
- Place the tip of the sprayer in each nostril and press down to release one full spray. Do not tilt your head back or sniff while you are spraying. The medication will work even if you have a stuffy nose, cold, or allergies.
- Wait 15 minutes and release one full spray in each nostril again.
- Dispose of the sprayer and ampule. Place a new unit dose spray in your assembly case so you will be ready for your next attack. Dispose of the assembly case after you have used it to prepare four sprayers.
Before using dihydroergotamine,
- tell your doctor and pharmacist if you are allergic to dihydroergotamine, other ergot alkaloids such as bromocriptine (Parlodel), ergonovine (Ergotrate), ergotamine (Cafergot, Ercaf, others), methylergonovine (Methergine), and methysergide (Sansert), or any other medications.
- do not take dihydroergotamine within 24 hours of taking ergot alkaloids such as bromocriptine (Parlodel), ergonovine (Ergotrate), ergotamine (Cafergot, Ercaf, others), methylergonovine (Methergine), and methysergide (Sansert); or other medications for migraine such as frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig).
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: beta blockers such as propranolol (Inderal); cimetidine (Tagamet); clotrimazole (Lotrimin); cyclosporine (Neoral, Sandimmune); danazol (Danocrine); delavirdine (Rescriptor); diltiazem (Cardizem, Dilacor, Tiazac); epinephrine (Epipen); fluconazole (Diflucan); isoniazid (INH, Nydrazid); medications for colds and asthma; metronidazole (Flagyl); nefazodone (Serzone); oral contraceptives (birth control pills); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil ), and sertraline (Zoloft); saquinavir (Fortovase, Invirase); verapamil (Calan, Covera, Isoptin, Verelan); zafirlukast (Accolate); and zileuton (Zyflo). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have a family history of heart disease and if you have or have ever had high blood pressure; high cholesterol; diabetes; Raynaud's disease (a condition that affects the fingers and toes); any disease that affects your circulation or arteries; sepsis (a severe infection of the blood); surgery on your heart or blood vessels; a heart attack; or kidney, liver, lung, or heart disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using dihydroergotamine, call your doctor immediately.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are using dihydroergotamine.
- tell your doctor if you use tobacco products. Smoking cigarettes while using this medication increases the risk of serious side effects.
- stuffy nose
- tingling or pain in the nose or throat
- dryness in the nose
- taste changes
- upset stomach
- extreme tiredness
- color changes, numbness or tingling in fingers and toes
- muscle pain in arms and legs
- weakness in arms and legs
- chest pain
- speeding or slowing of heart rate
- cold, pale skin
- slow or difficult speech