Ergotamine/caffeine, sold under the brand name Cafergot among others, is a fixed-dose combination medication used for the treatment of migraine. It contains ergotamine, as the tartrate, an alpha adrenergic blocking agent; and caffeine, a cranial vasoconstrictor.[3]
Ergotamine/caffeine is indicated as therapy to abort or prevent vascular headache.[1][2]
Mechanism of action
Ergotamine binds to 5HT 1b/d receptors.[4] This along with binding to other serotonergic and dopaminergic receptors is their presumed mechanism of action in treating migraine.[4][5]
Adverse effects
Because the vasoconstrictive effects of ergotamine and caffeine are not selective for the brain, adverse effects due to systemic vasoconstriction can occur. Cold feet or hands, angina pectoris, myocardial infarction,[6] or dizziness are some examples.
It has also been shown to be associated with mitral valve stenosis. [7]
^Diener HC, Jansen JP, Reches A, Pascual J, Pitei D, Steiner TJ (2002). "Efficacy, tolerability and safety of oral eletriptan and ergotamine plus caffeine (Cafergot) in the acute treatment of migraine: a multicentre, randomised, double-blind, placebo-controlled comparison". European Neurology. 47 (2): 99–107. doi:10.1159/000047960. PMID11844898. S2CID72629130.
^Olesen J, Goadsby PJ, Ramadan NM, Tfelt-Hansen P, Michael K, Welch A, eds. (2006). The Headaches (3rd ed.). Lippincott Williams and Wilkins. p. 463. ISBN978-0781754002.
^Austin SM, el-Hayek A, Comianos M, Tamulonis DJ (October 1993). "Mitral valve disease associated with long-term ergotamine use". Southern Medical Journal. 86 (10): 1179–1181. doi:10.1097/00007611-199310000-00024. PMID8211344.
