Cafergot (ergotamine / caffeine) is used to treat cluster headaches and migraines in adults. It's available as a tablet that's taken by mouth, as well as a suppository that's inserted into the rectum. Typically, you take a dose as soon as you feel a headache coming on. But there's a limit to how many doses you can take each week because taking this medication too often can lead to serious side effects, such as vomiting and numbness. Brand name Cafergot is discontinued.
Headache pain caused by swollen or widened blood vessels (vascular headaches)
Cafergot (ergotamine / caffeine) is a combination of two medications. Ergotamine (an ergot derivative) and caffeine (a nonselective PDE inhibitor) tighten blood vessels and calm certain parts of the brain to relieve the pain of your headaches.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Suppository is a good option for people who've trouble swallowing pills
Tablet is available as a lower-cost generic
Can start to feel relief after a half hour (for the tablets) or an hour (for the suppository); and you may take an additional dose if no relief
Not for daily or long-term use
Can't take while pregnant
Not safe for use for people with kidney or liver problems
Rectal suppository is brand name only and requires refrigeration
Take Cafergot (ergotamine / caffeine) as soon as you feel a headache or migraine coming on. Since these attacks can happen anywhere, it's a good idea to carry Cafergot (ergotamine / caffeine) with you at all times, especially if you have the tablet form (the suppository needs to be kept in the refrigerator).
Take Cafergot (ergotamine / caffeine) exactly as prescribed and only when needed. Don't take it for long periods of time since this can lead to serious side effects, including blood circulation problems. Taking Cafergot (ergotamine / caffeine) long term can also cause your body to become dependent on it and can even cause rebound headaches.
Take the tablet with or without food. Food won't affect how well this medication works to treat your headache.
If you're using the suppository, store them in the refrigerator. Make sure to remove the foil wrapper before inserting it rectally. Insert the pointed end first. Try to use the medication as soon as you take it out, before it starts to melt.
Cafergot (ergotamine / caffeine) is known to cause birth defects. Don't take this medication if you're pregnant or think you may be pregnant. If necessary, use a good form of birth control to prevent accidental pregnancy.
If you're breastfeeding, don't take Cafergot (ergotamine / caffeine). Ergotamine can pass into your breast milk and cause side effects, such as vomiting, diarrhea, weak pulse, and unstable blood pressure, in your baby.
Cafergot (ergotamine / caffeine) works similarly to triptan medications, like sumatriptan (Imitrex) or rizatriptan (Maxalt), and has very similar side effects. Taking them at the same time can lead to dangerously high blood pressure and other serious side effects. Don't take these medications together or within 24 hours of each other.
Don't take Cafergot (ergotamine / caffeine) if you have heart disease or blood vessel problems because it can worsen your condition. Make sure to tell your healthcare team about your full medical history before starting this medication.
Certain medications can affect the levels of Cafergot (ergotamine / caffeine) in your body and raise your risk of side effects. Make sure your healthcare team and pharmacist know all of the medications that you take, so they can help you watch out for dangerous drug interactions.
If you're taking Cafergot (ergotamine / caffeine), it's best to avoid other forms of caffeine such as coffee, tea, or energy drinks. One tablet or suppository contains 100 mg of caffeine, which is about the amount of caffeine in one cup of coffee.
Cafergot (ergotamine / caffeine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Taking macrolide antibiotics or protease inhibitors | Taking more Cafergot (ergotamine / caffeine) than prescribed
Certain medications can raise the levels of Cafergot (ergotamine / caffeine) in your body. Higher levels can make your blood vessels too narrow and affect blood flow to your brain (which can cause a stroke) or hands and feet (which can cause tissue death). Don't take Cafergot (ergotamine / caffeine) with protease inhibitors (which are usually used for HIV) or macrolide antibiotics, such as erythromycin (Ery-Tab) or clarithromycin. There are several other medications that have the potential to raise Cafergot (ergotamine / caffeine) levels in your body. Examples of these include nefazodone (Serzone), fluoxetine (Prozac), and metronidazole (Flagyl). Let your healthcare team and pharmacist know all of the medications that you take, so they can make sure your medications are safe to take together. Get medical help right away if you have pain in your hands or feet, numbness, coldness, or if you're pale in color. Call 911 if you have any symptoms of a stroke, such as weakness on one side of your body, slurred speech, and drooping face.
Risk factors: Taking Cafergot (ergotamine / caffeine) daily or for a long period of time
In some rare cases, people have experienced fibrosis (scarring) in their stomach, lungs, or heart after taking Cafergot (ergotamine / caffeine). Take Cafergot (ergotamine / caffeine) only as needed. If you find that you need to take this medication every day, talk to your care team about alternative treatment options for your headaches.
Risk factors: Allergy to aspirin
Cafergot (ergotamine / caffeine) tablets contain yellow #5 dye, which is also known as tartrazine. Although rare, tartrazine can cause allergic reactions, such as airway tightening and difficulty breathing. Talk to your healthcare professional or pharmacist if you have an allergy to tartrazine or yellow dye.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
1mg/100mg | 30 tablets | $112.30 | $3.74 |
Oral tablet: Each tablet contains 1 mg of ergotamine and 100 mg of caffeine. The typical dose is 2 tablets by mouth as soon as you feel a headache coming on. Take 1 more tablet every 30 minutes as needed. Don't take more than 6 tablets per headache episode or more than 10 tablets per week.
Rectal suppository (Migergot): Each suppository contains 2 mg of ergotamine and 100 mg of caffeine. The typical dose is 1 suppository inserted rectally as soon as you feel a headache coming on. Take 1 more suppository after 1 hour if you need more relief. Don't use more than 2 suppositories per headache episode or more than 5 suppositories per week.
Taking medications that raise the levels of Cafergot (ergotamine / caffeine) in your body, such as macrolide antibiotics and protease inhibitors
Currently pregnant or might become pregnant
Blood vessel problems in the hands or feet (peripheral vascular disease)
Heart disease
High blood pressure
Liver or kidney disease
Sepsis (serious complication due to an infection)
Headache pain caused by swollen or widened blood vessels (vascular headaches)
Treatment of migraine attacks with or without aura in people age 12 years and older
Migraine headaches
Cluster headaches – injection form only
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A randomized, double-blind comparison of sumatriptan and Cafergot in the acute treatment of migraine: The Multinational Oral Sumatriptan and Cafergot Comparative Study Group. (1991). European Neurology.
Cintex Services, LLC. (2021). Ergotamine tartrate and caffeine tablet, film coated [package insert]. DailyMed.
Cosette Pharmaceuticals, Inc. (2022). Migergot- ergotamine tartrate and caffeine suppository [package insert]. DailyMed.
MedlinePlus. (2023). Vascular headaches.
Ngo, M., et al. (2023). Ergotamine/caffeine. StatPearls.
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