D.H.E. 45 (dihydroergotamine) for the treatment of migraine headaches: an introduction

D.H. E. 45 is an injection for treating migraines and is also used for treating cluster headaches. It is not recommended for preventing migraines or for treating hemiplegic migraine or basilar migraines. The full name of the drug is Dihydroergotamine.

How D.H.E. 45 works

D.H.E. 45 activates certain receptors in the brain. This action is believed to cause blood vessels in the brain to narrow, therefore relieving migraine symptoms. Migraine pain and symptom relief might also come from the drug preventing release of agents that lead to inflammation.

Forms of D.H.E. 45 available to treat migraines

D.H.E. 45 is an injectable medication. It can be injected at home and is used in emergency rooms to treat severe migraines. Hospitals may use the intravenous form of the drug.

Most common side effects of D.H.E. 45 injections

• Dizziness
• Headache
• Nausea and Vomiting
• Diarrhea
• Flushing
• Increased sweating

In rare occasions, D.H.E. 45 may cause a lack of blood flow to the hands, feet and brain.

Serious side effects

If you experience any of the following symptoms, seek medical attention immediately:

• Rapid, slow or irregular heartbeat
• Leg weakness or muscle pain in legs or arms
• Chest pain
• Vision changes
• Dizziness
• Confusion
• Weakness on one side of the body
• Slurred speech
• Blue hands and feet
• Swelling
• Itching
• Coldness, pain, burning, loss of feeling or tingling in fingers and toes
• Whitish fingers, toes or nails
• Bluish hands or feet
• Muscle pain or weakness
• Severe stomach or abdominal pain
• Lower back pain
• Little or no urine

Who should not use D.H.E. 45

Do not take D.H.E. 45 if you you’re pregnant or nursing or if you have any disease of the heart, arteries or circulation.

Talk to your doctor before taking D.H.E. 45 if you have high blood pressure, chest pain, shortness of breath, heart disease or have had any surgery on the arteries of your heart.

Your doctor should also know if you have any heart disease risk factors such as high cholesterol, obesity, diabetes, smoking, family history of heart disease or if you’re a postmenopausal woman or a man over age 40.

Also speak to your doctor if you have kidney or liver disease, or if you have any problems with blood circulation in your toes, fingers, arms or legs.

Your doctor should know all other medications you take, particularly those for migraine, blood pressure, antibiotics and erythromycin.

Do not take D.H.E. 45 if you take protease inhibitors or azole antifungals.

Tell your doctor if you experience a headache that is different than your previous migraine attacks.

Migraine medicine meter

Use the following scale to rate your most recent experience with D.H.E. 45:

As always, the best source for advice on treating your migraines is your own migraine specialist. These medication descriptions are provided only for informational purposes. You should begin no medication regimen without first checking with your physician. Again, this information should in no way substitute or be mistaken for medical advice.

Written by: Otesa Miles / Reviewed by: John-Claude Krusz, PhD, MD | Last review date: November 2010. Click the References Link below for a complete list of references.

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