The mechanism of action is blocking α-adrenergic and dopaminergic receptors. It has long-lasting, direct contractile effects on the smooth muscle of peripheral and cerebral vessels. Dihydroergotamine has a stronger blocking effect on α-adrenergic and dopaminergic receptors and a significantly weaker effect of shrinking vessels from ergotamine. Dihydroergotamine acts on central serotoninergic neurons, which play an important role in the mechanism of antimigraine action. It exerts a selective effect on the venous system vessels, reducing the capacity of these vessels with a significantly weaker effect on vascular resistance of the arteries and arterioles (it prevents venous stasis and accelerates venous return and remains without significant influence on peripheral vascular resistance). Bioavailability after oral administration does not exceed 5%, the maximum serum concentration reaches after about 30 minutes. up to 3 h. Metabolized in the liver. The main metabolite - 8-hydroxy-dihydroergotamine is pharmacologically active.
Contraindications:
Hypersensitivity to ergot alkaloids or any of the excipients. Impaired renal or liver function. Coronary heart disease (previous myocardial infarction, angina pectoris,Prinzmetal's angina). Peripheral vascular disease (Raynaud's symptoms, obliterative vasculitis, thrombophlebitis). Condition after surgical procedures on vessels. Uncontrolled overpressure. Pregnancy. Breastfeeding period.
Precautions:
The drug contains ethanol. Use with caution in patients with arrhythmias. The drug is not intended for long-term therapy. In patients with frequent or daily headaches, despite the regular use of medications against these pains, consideration should be given to diagnosing a headache depending on the continuous use of medications. If a patient with long-term painkillers gets a headache, the drug should be discontinued. Dihydroergotamine should not be used to prevent migraine pain. The efficacy and safety of use in children has not been established. Due to the lactose content, the drug should not be used in patients with rare hereditary galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose.
Pregnancy and lactation:
It should not be used during pregnancy (it is thought that dihydroergotamine may be embryotoxic). It should not be used during breast-feeding, as dihydroergotamine is excreted in human milk and can cause various types of disorders in breast-fed children. The ergot alkaloids inhibit prolactin secretion.
Side effects:
The following may occur: paresthesia, weakness in the limbs, pain and dizziness, confusion, drowsiness, long-term use of high doses may lead to convulsions; arrhythmias, increase or decrease in blood pressure, ischemia or myocardial infarction, coronary spasm, long-term use may lead to ergotism (initially manifested by numbness and cold of the hands and feet, in the Next stage circulatory disturbance in the extremities, long-lasting contraction of blood vessels and, consequently, necrosis of the limbs); nausea, gastrointestinal discomfort, epigastric pain, diarrhea, constipation, dryness in the mouth; with prolonged use, damage to the liver and kidneys may occur; erythema, edema, petechiae, epidermal necrolysis, acne.
Dosage:
Orally. Adults and children aged> 16 years: 1-2 tabl. 3 times a day.
(C)
