User:Mr. Ibrahem/Dihydroergotamine

From Wikipedia, the free encyclopedia
Mr. Ibrahem/Dihydroergotamine
Clinical data
Pronunciation/daɪˌhaɪdroʊ.ɜːrˈɡɒtəmiːn/ dy-HY-droh-ur-GOT-ə-meen
Trade namesD.H.E. 45, Migranal, others
Other namesDHE; (5'α)-9,10-Dihydro-12'-hydroxy-2'-methyl-5'-(phenylmethyl)-ergotaman-3',6',18-trione
AHFS/Drugs.comMonograph
MedlinePlusa603022
License data
Routes of
administration		Nasal spray, SC, IM, IV[1]
Legal status
Legal status
Pharmacokinetic data
Bioavailability32% (nasal spray)
Onset of actionWithin 5 min (IV), About 30 min (IN)[2]
Elimination half-life9 hours
ExcretionBile
Identifiers
  • (2R,4R,7R)-N-[(1S,2S,4R,7S)-7-benzyl-2-hydroxy-4-methyl-5,8-dioxo-3-oxa-6,9-diazatricyclo[7.3.0.02,6]dodecan-4-yl]-6-methyl-6,11-diazatetracyclo[7.6.1.02,7.012,16]hexadeca-1(16),9,12,14-tetraene-4-carboxamide
Chemical and physical data
FormulaC33H37N5O5
Molar mass583.689 g·mol−1
3D model (JSmol)
  • [H][C@]56C[C@@H](C(=O)N[C@]1(C)O[C@]4(O)N(C1=O)[C@@H](Cc2ccccc2)C(=O)N3CCC[C@]34[H])CN(C)[C@]5([H])Cc7c[nH]c8cccc6c78
  • InChI=1S/C33H37N5O5/c1-32(35-29(39)21-15-23-22-10-6-11-24-28(22)20(17-34-24)16-25(23)36(2)18-21)31(41)38-26(14-19-8-4-3-5-9-19)30(40)37-13-7-12-27(37)33(38,42)43-32/h3-6,8-11,17,21,23,25-27,34,42H,7,12-16,18H2,1-2H3,(H,35,39)/t21-,23-,25-,26+,27+,32-,33+/m1/s1 checkY
  • Key:LUZRJRNZXALNLM-JGRZULCMSA-N checkY
  (verify)

Dihydroergotamine (DHE), sold under the brand name Migranal among others, is a medication used to treat migraines, cluster headaches, and medication overuse headaches.[2][3] It has a particular benefit in hard to treat migraines.[4] It may be used as a nasal spray or by injection.[1] Onset is within 5 to 30 minutes.[2]

Common side effects include high blood pressure, flushing, sweating, and nausea.[2] Other side effects may include myocardial ischemia, stroke, arrhythmia, and ergotism.[2] Use is not recommended during pregnancy, in those with liver or kidney problems, or those with vascular disease.[1] It is a derivative of ergotamine.[4] It activates serotonin receptors as well as dopamine and adrenergic receptors.[4]

Dihydroergotamine was first made in 1943 and has been in medical use since.[1][4] It is available as a generic medication.[5] In the United States it costs about 45 USD per dose by injection and 370 USD per dose in the nose as of 2021.[5][6] As of the 2010s it is less commonly used than triptans.[7]

References[edit]

  1. ^ a b c d Levin, Morris (8 May 2008). Comprehensive Review of Headache Medicine. Oxford University Press, USA. p. 217. ISBN 978-0-19-536673-0. Archived from the original on 28 August 2021. Retrieved 23 July 2021.
  2. ^ a b c d e f g h i "Dihydroergotamine Monograph for Professionals". Drugs.com. Archived from the original on 6 March 2021. Retrieved 23 July 2021.
  3. ^ a b Shafqat, R; Flores-Montanez, Y; Delbono, V; Nahas, SJ (2020). "Updated Evaluation of IV Dihydroergotamine (DHE) for Refractory Migraine: Patient Selection and Special Considerations". Journal of pain research. 13: 859–864. doi:10.2147/JPR.S203650. PMID 32431533.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  4. ^ a b c d Silberstein, SD; Shrewsbury, SB; Hoekman, J (January 2020). "Dihydroergotamine (DHE) - Then and Now: A Narrative Review". Headache. 60 (1): 40–57. doi:10.1111/head.13700. PMID 31737909.
  5. ^ a b "Dihydroergotamine Mesylate Prices and Dihydroergotamine Mesylate Coupons - GoodRx". GoodRx. Retrieved 23 July 2021.
  6. ^ "Dihydroergotamine Prices, Coupons & Patient Assistance Programs". Drugs.com. Archived from the original on 7 August 2019. Retrieved 23 July 2021.
  7. ^ Singh, Mamta; Bhatia, Rohit (April 2011). Emergencies in Neurology. Byword Books Private Limited. p. 155. ISBN 978-81-8193-067-5. Archived from the original on 2021-08-29. Retrieved 2021-07-23.
Retrieved from "https://en.wikipedia.org/w/index.php?title=User:Mr._Ibrahem/Dihydroergotamine&oldid=1210967915"