Migranal Nasal Spray

Generic Name: Dihydroergotamine

  • What is Migranal Nasal Spray?

    Migranal is a nasal spray used for relief of migraine headache attacks, whether or not preceded by an aura (visual disturbances, usually including sensations of halos or flickering lights). Migranal is also available as an injection.

    Migranal is not approved to prevent migraines or to treat hemiplegic or basilar migraines.

  • What is the most important information I should know about Migranal Nasal Spray?

    When Migranal is used in combination with certain types of medications including a class of antibiotics that includes troleandomycin, clarithromycin or erythromycin, as well as HIV medications known as protease inhibitors, serious and life-threatening oxygen deprivation of the tissues in the arms, legs, and brain can occur.

    Do not use Migranal to prevent a headache if you have no symptoms, or to treat common tension headaches, or a headache that is not at all typical of your usual migraine headache. When using Migranal, you should not exceed the dose prescribed by your doctor and you should not use Migranal on a daily basis.

    Do not use Migranal within 24 hours of taking a 5-HT1 agonist (e.g., sumatriptan), ergotamine-containing or ergot-type medication, or methysergide. Ask your doctor or pharmacist if any of your other medications are in this class.

    Migranal should not be used if you are pregnant, plan to become pregnant, or are nursing.

  • Who should not take Migranal Nasal Spray?

    Do not take Migranal if you are allergic or sensitive to ergot alkaloid medications or any of the ingredients in Migranal nasal spray.

    You should not use Migranal if you are pregnant or nursing; have any disease affecting your heart, arteries, or circulation; have uncontrolled high blood pressure; are taking certain anti-HIV medications (protease inhibitors); or are taking a macrolide antibiotic such as troleandomycin, clarithromycin or erythromycin.

    Migranal is not for the treatment of hemiplegic or basilar migraine.

  • What should I tell my doctor before I take the first dose of Migranal Nasal Spray?

    Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Migranal. Make sure your doctor knows if you have any of the following conditions: previous surgery on your heart arteries, chest pain, heart disease, liver or kidney disease, problems with blood circulation in your arms or legs, fingers, or toes, shortness of breath, and uncontrolled high blood pressure. Also, talk to your doctor about your complete medical history, especially if you smoke, are pregnant or plan to become pregnant, or are breastfeeding.

  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

    Adults: The usual dosage is one spray (0.5 milligrams of Migranal) in each nostril at the first symptom of a headache. Repeat 15 minutes later. The total dosage is four sprays (2 mg Migranal).

  • How should I take Migranal Nasal Spray?

    Once a new applicator has been prepared, prime the pump four times before spraying into your nostrils.

    Do not sniff or tilt your head back when spraying the medicine into your nostrils.

    Discard any remaining solution 8 hours after you first opened it. Dispose of your Migranal nasal sprayer and the opened vial after use; do no reuse.

    Migranal nasal spray should not be used on a daily basis.

  • What should I avoid while taking Migranal Nasal Spray?

    Do not use Migranal while you are pregnant or breastfeeding.

    Do not use Migranal within 24 hours of taking another ergotamine-based drug, or another migraine remedy. Also avoid combining Migranal with other drugs that constrict the blood vessels.

  • What are possible food and drug interactions associated with Migranal Nasal Spray?

    If Migranal is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Migranal with the following: anti-HIV medications such as ritonavir, nelfinavir, indinavir, and saquinavir; clotrimazole; fluconazole; fluoxetine; fluvoxamine; grapefruit juice; itraconazole; ketoconazole; macrolide-type antibiotics such as erythromycin, clarithromycin, and troleandomycin; nefazodone; nicotine; paroxetine; propranolol; sertraline; sumatriptan; vasoconstrictors; and zileuton.

  • What are the possible side effects of Migranal Nasal Spray?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects may include: application-site reactions, dizziness, nausea, runny nose, sore throat, tiredness, vomiting, weakness

    When using Migranal, tell your doctor immediately if you experience numbness or tingling in your fingers and toes; pain, tightness, or discomfort in your chest; muscle pain or cramps in your arms and legs; weakness in your legs; temporary speeding or slowing of your heart rate; or swelling or itching of any part of your body.

  • Can I receive Migranal Nasal Spray if I am pregnant or breastfeeding?

    You should not use Migranal if you are pregnant or plan to become pregnant. If taken during pregnancy, Migranal can potentially cause serious injury to the fetus. If you become pregnant while using Migranal, you should stop taking the drug and tell your doctor immediately. Migranal is likely excreted in breast milk. Do not use Migranal if you are breastfeeding. Tell your doctor immediately if you are breastfeeding or plan to breastfeed.

  • What should I do if I miss a dose of Migranal Nasal Spray?

    If you do not use Migranal at the beginning of a headache, instill a dose as soon as you remember.

  • How should I store Migranal Nasal Spray?

    Store at room temperature and protect from heat and light.

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