Migranal Nasal Spray

Generic name: Dihydroergotamine mesylate

What is Migranal Nasal Spray?

Migranal Nasal Spray is used for relief of migraine headache attacks, whether or not preceded by an aura (visual disturbances, usually including sensations of halos or flickering lights). It is not indicated to prevent migraines.

This nasally administered remedy constricts the blood vessels, and may defeat migraine through this action. Migranal is also available as an injection.

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 macrolide antibiotics, such as troleandomycin, clarithromycin or erythromycin, and HIV medications known as protease inhibitors, serious and life-threatening oxygen deprivation of the tissues in the arms, legs, and brain can occur.

You should 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.

Migranal should not be used if you are pregnant or nursing.

Who should not take Migranal Nasal Spray?

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

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 medication you are taking before beginning treatment with Migranal. Also, talk to your doctor about your complete medical history, especially if you smoke, are pregnant or plan to become pregnant, or are breastfeeding. Make sure your doctor knows if you have any of the following conditions: a history of 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.

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 1 spray (0.5 milligrams of Migranal) in each nostril at the first symptom of a headache. Fifteen minutes later, one more spray of Migranal should be administered in each nostril. The total dosage is 4 sprays (2 milligrams Migranal).

How should I take Migranal Nasal Spray?

Once a new applicator has been prepared, the pump should be primed (sprayed first) 4 times before spraying into your nostrils. You should discard any remaining solution 8 hours after you first opened it. Do not sniff or tilt your head back when spraying the medicine into your nostrils.

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. Migranal should not be used if you are breastfeeding your child. 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.