Neurology Book

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Intranasal DihydroergotamineAka: Migranal

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  1. Indications
    1. Migraine Abortive Management
  2. Efficacy
    1. Significant Migraine response in 30 minutes
      1. Migranal: 70%
      2. Placebo: 28%
    2. Reference
      1. Gallagher (1996) Arch Neurol 53:1285
  3. Dosing
    1. Prepare sprayer by inserting ampule and prime pump
    2. Use one spray each nostril
    3. May repeat x1 after 15 minutes (Total dose = 2mg)
    4. Maximum use is 2 times per week
  4. Advantages
    1. Lasts longer than intranasal Imitrex
    2. Rebound Headache less common than Imitrex
      1. Rebound Headache Incidence: 15% within 24 hours
    3. Less expensive than Intranasal Imitrex ($16/dose)
  5. Disadvantages
    1. Does not work as fast as intranasal Imitrex
    2. More complicated to use than intranasal Imitrex
  6. Adverse Effects
    1. Rhinitis
    2. Nausea
    3. Taste perversion

Migranal (C0086157)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishDihydergot, Dihydroergotamine Sandoz, Migranal, Novartis Brand of Dihydroergotamine Mesylate, Xcel Brand 1 of Dihydroergotamine Mesylate
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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