Migraine is not just a headache, as anyone who suffers from it knows. Only those who suffer from it know the pain of not being able to do anything all day, not being able to look at the light, and feeling nauseous. So, there are special medications that doctors prescribe for such severe headaches. Today we are talking about one such medicine, Ergotamine and Caffeine-containing pills. Let's talk about this medicine simply and in a friendly way.
What really happens with this medicine?
Simply put, the Ergotamine in this medicine belongs to a group of medicines called `ergot alkaloids`. When a migraine occurs, the blood vessels in the brain swell and widen. Ergotamine works by narrowing those wide blood vessels. This reduces the pain of the headache.
What about Caffeine? Caffeine speeds up the absorption of Ergotamine into the body and increases its effectiveness. This means that when these two are combined, they can provide quick relief from headaches. This medicine is used to treat migraines as well as another severe type of headache called `Cluster Headaches`.
Things you need to tell your doctor before taking medicine
Before using this medicine, it is very important to inform your doctor about your health condition completely. Because using this medicine with some medical conditions can be dangerous. If you have any of the conditions below, be sure to tell your doctor.
| Health condition or opportunity | Why should you inform? |
|---|---|
| Heart disease or blood vessel disease | Because this medication narrows blood vessels, it can be dangerous for heart patients. |
| High Blood Pressure | The medication can further increase blood pressure. |
| Kidney or liver disease | The process of removing medication from the body may be affected. |
| Poor blood circulation in the body | Problems such as decreased blood supply to the hands and feet can become more severe. |
| If you are pregnant, trying to get pregnant, or are a breastfeeding mother | This medicine should not be used as it may be harmful to the child. |
| Allergies to other medicines, foods or substances | It is important to know if you are allergic to any of the ingredients in the medicine. |
How should I use the medicine?
This is not a medicine that you take regularly like a regular painkiller.
The most important thing is to take this medicine as soon as the migraine starts, that is, when you feel the first symptoms. If you take it too late, the medicine may be less effective.
Take this pill with a glass of water. Use only the dose prescribed by your doctor. Never take more than the prescribed dose. And do not stop taking the medicine without your doctor's advice.
What to do if you take too much medicine? (Overdose)
If you think you have taken too much of this medicine, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital for advice. Treat this as an emergency.
Do not share the medicine with others.
This medicine has been prescribed for you only. Never share this medicine with others, even if your symptoms are similar to yours.
Can other medications interact with this medicine?
Yes, this is a very important point. Ergotamine; Caffeine can interact with many other medications. So, tell your doctor about all the medications you are taking (including vitamins and herbal remedies).
In particular, if you are taking any of the medications listed below, it is not recommended to use this medicine.
- Antifungal drugs - e.g. ketoconazole, itraconazole
- Some antibiotics - e.g. erythromycin, clarithromycin
- Protease inhibitors are drugs used to treat HIV/AIDS.
- Other migraine medications (triptans) - e.g. sumatriptan, rizatriptan
- Grapefruit juice
This list is not complete. Therefore, it is very important for your safety to tell your doctor about all the medications you are taking.
Other things to consider when taking the medicine
- If the pain doesn't go away: If your headache doesn't go away after taking this medicine, talk to your doctor. You may need a different medicine.
- Sensitivity to cold: This medicine may reduce blood flow to the hands, feet, and fingers. This can make you feel sensitive to cold. This can be especially true for older people. Therefore, dress well on cold days and be careful of the cold.
- Be careful with caffeine: Since this medicine already contains caffeine, limit your intake of coffee, tea, chocolate, and some caffeinated beverages on the days you take the medicine. Otherwise, the body may get too much caffeine and may experience problems.
- Risk of increased headaches due to medication: This is something that many people don't know. If you take migraine medication for more than 10 days a month, it can cause an increase in headaches. This is called a 'medication-overuse headache'. Therefore, it is a good idea to keep a diary of the days you have headaches and the days you took the medication. If you notice that your headaches are becoming more frequent, inform your doctor.
What are the possible side effects?
Like any medicine, this medicine can cause side effects. Some are serious, some are common. See the table below.
| Side Effect | What to do? |
|---|---|
| Side effects that should be reported to the doctor immediately | |
| Allergic reactions - skin rash, itching, swelling of the face/lips/tongue | Tell your doctor immediately or go to a hospital. |
| Chest pain, tightness, or difficulty breathing | |
| Coldness, pain, or numbness in the hands or feet | |
| Fast, slow , or irregular heartbeat | |
| Severe stomach pain, vomiting | |
| Swelling of the hands, feet, or ankles | |
| Seizures | |
| Side effects that are usually not serious | |
| Nausea | If these persist or become bothersome, inform your doctor. |
| Increased frequency of urination | |
Take-Home Message
- This medicine should only be taken when a migraine starts. It is not a daily medication.
- Be sure to tell your doctor about all other medications you are taking, especially other migraine medications.
- If you experience symptoms such as chest pain, numbness in the limbs, or feeling cold, seek medical advice immediately.
- Using this type of medication for more than 10 days a month can make headaches worse. So be careful with your medication.
- Keep this medicine out of the reach of children, at room temperature, away from light and moisture.
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