d. Methysergide Maleate (Sansert). Methysergide maleate is used to prevent
the occurrence of migraine headaches. Hence, this product is taken on a daily basis by
the patient. This product is available in a 2.0 milligram tablet. The usual dosage of the
product is 4 to 8 milligrams per day. Methysergide maleate can be used for persons
who are not responsive to other types of ergot alkaloids. Furthermore, this drug is used
by people who are disabled by their migraine headaches. Sansert is usually taken with
meals. Typically, a patient who takes this product is told by the physician not to take the
medication for three to four weeks of every six months in order to allow the body to
deplete some of the ergot alkaloids. This helps to prevent ergotism.
e. Ergotamine Tartrate, Phenobarbital, and Belladonna Alkaloids
(Bellergal, Bellergal-S). This product is not typically used in the management of
migraine headaches, although it is an ergot alkaloid preparation. Instead, it is used in
the management of nervous disorders and disorders characterized by exaggerated
autonomic response. Some menopausal, cardiovascular, gastrointestinal, and
genitourinary disorders fall into these categories. Bellergal is available in tablet form
with the usual dosage being one tablet in the morning, one tablet at noon, and two
tablets at bedtime. Bellergal-S, an extended action tablet dosage form, has a usual
dosage of one tablet in the morning and one tablet in the evening. Bellergal and
Bellergal-S may cause drowsiness as a side effect. You should caution the patient
receiving this medication that alcohol should not be consumed when taking this
medication.
11-13. CONTRAINDICATIONS FOR OXYTOCICS AND ERGOT ALKALOID
PRODUCTS
Both the oxytocics and the products containing ergot alkaloids produce
vasoconstriction. Consequently, these categories of drugs are contraindicated in
patients who have peripheral vascular disease (PVD), cardiac or pulmonary disease,
impaired renal or hepatic function, hypertension, or are in the third trimester of
pregnancy. The contraindication is especially true for ergot alkaloids taken by pregnant
women in the management of migraine headaches.
MD0807
11-8