vasoconstriction leading to gangrene, vomiting, and convulsions with a possible loss of
consciousness and death.
11-12. SPECIFIC ERGOT AGENTS
The following ergot agents are commonly dispensed to patients.
a. Ergotamine Tartrate (Gynergen, Ergomar). Ergotamine tartrate is used
in the management of migraine headaches. This product is available in both an
injection and in a tablet dosage form. The usual dosage for injection is 0.5 to 1.0
milliliter given intramuscularly (IM). The usual dosage of the tablets is two to six tablets
per attack given at one-half hour intervals. The main concern associated with ergot
therapy is ergotism (see para 11-11). In order to prevent ergotism, the maximum dose
for the injection is two milliliters per week, while the maximum dosage for the tablets is
six tablets per day, 10 tablets per week, or 30 tablets per month. It is imperative that
the patient be informed of the dosage restrictions for the tablet form. Ergomar is
available only in buccal tablet form. The usual dose of this product is one tablet
administered buccally every 30 minutes as needed. The dosage is not to exceed three
per day or five per week.
b. Ergotamine Tartrate with Caffeine (Cafergot). Cafergot is commonly
used in the treatment of migraine headaches. It is useful in the management of
migraine headaches because the caffeine enhances the effect of the ergotamine
tartrate in constricting the blood vessels of the brain. The usual dosage is two tablets at
the onset of a headache and one tablet every 30 minutes after until, if necessary, a
maximum of six tablets are taken. If the patient is using the suppository form of the
product, the usual dose is one suppository at the onset of a headache and another
suppository after one hour, if necessary, until a maximum of two suppositories are
inserted. Ergotism is seen in patients who take high doses of this medication. With the
tablet dosage form, the maximum number of tablets to be taken per day is 6, per week
is 10, and per month is 30. With the suppository dosage form, the maximum number
per day is two and per week is five.
c. Ergotamine Tartrate with Caffeine and Pentobarbital (Cafergot P-B).
This product is used in the treatment of migraine headaches. The pentobarbital is
added for its sedative effect. The product is supplied in both tablet and suppository
dosage forms. The usual dose of the tablet form is two tablets at the onset of a
migraine headache and one tablet every one-half hour. The maximum number of
tablets which can be taken per day is 6, per week is 10, and per month is 30. The
dosage of the suppository form is one suppository at the onset of a migraine headache
and one suppository after one hour. The maximum number of suppositories is two per
day and five per week. This preparation may cause drowsiness because of the
sedative effect produced by pentobarbital. The patient should be cautioned not to drink
alcohol while under the influence of this medication.