DHE 45® (dihydroergotamine mesylate)

D.H.E. 45 is an injection for treating migraine (with or without aura) and is also used for treating cluster headaches. It is not recommended for preventing migraine attacks or for treating hemiplegic migraine or basilar migraine.

How D.H.E. 45 works on migraine

It is believed that D.H.E. 45 causes blood vessels in the brain to constrict or narrow, relieving migraine symptoms. In addition, D.H.E. 45 may prevent the release of certain chemicals in the brain that lead to inflammation.

Response from the community: Was D.H.E. 45 effective in relieving your migraine symptoms?

We surveyed our community to find out how effective members found D.H.E. 45 in relieving their migraine symptoms. Twenty percent said D.H.E. 45 completely eliminated their symptoms, and another 17% found it significantly reduced their symptoms. However, 21% said it didn’t help them at all.

Was D.H.E. 45 effective in relieving your migraine symptoms? (1,082 total votes)

  • Not at all (21% | 230 Votes)
  • Slightly eased symptoms (17% | 183 Votes)
  • Cut symptoms in half (11% | 122 Votes)
  • Reduced symptoms significantly (30% | 326 Votes)
  • Eliminated all symptoms (20% | 221 Votes)

Possible side effects of D.H.E. 45

D.H.E. 45 has a black box warning, the strongest warning by the U.S. Food and Drug Administration (FDA) because it may cause peripheral ischemia (insufficient blood flow to the arms or legs). Peripheral ischemia is serious and can be life-threatening.

The most common side effects experienced by patients taking D.H.E. 45 in clinical trials were:

In addition to peripheral ischemia, D.H.E. 45 may cause other serious side effects, such as a sudden constriction of a blood vessel (vasospasm), a rapid heart rate, stroke or other cerebrovascular disease, or ergotism, a type of poisoning that may result in headache, vomiting, diarrhea, and gangrene of the fingers or toes.

Patients taking D.H.E. 45 should talk to their doctor immediately if they experience any of the following symptoms:

  • Numbness or tingling in the fingers and toes
  • Muscle pain in the arms and legs
  • Weakness in the legs
  • Pain in the chest
  • Temporary speeding or slowing of the heart rate
  • Swelling
  • Itching

Response from the community: How would you rate the side effects you experienced with D.H.E. 45?

When asked about side effects, 23% of community members said they didn’t have any and 26% had only slight discomfort from side effects of D.H.E. 45. Twenty-five percent of our community members surveyed said they experienced noticeable side effects with D.H.E. 45. Another 11% said the side effects limit their use of the medication, and 15% said they will not use D.H.E. 45 because of the side effects.

How would you rate the side effects you experienced with D.H.E. 45? (885 total votes)

  • No side effects (23% | 201 Votes)
  • Slight discomfort from side effects (26% | 233 Votes)
  • Noticeable side effects (25% | 221 Votes)
  • Side effects will limit my use (11% | 97 Votes)
  • Will not use due to side effects (15% | 133 Votes)

Other things to know about D.H.E. 45

Do not take D.H.E. 45 if you you’re pregnant or nursing or if you have heart disease, arterial disease, or any problems with blood circulation in your toes, fingers, arms or legs.

Before taking D.H.E. 45, talk to your doctor about all your health conditions particularly if you have high blood pressure, chest pain, shortness of breath, kidney disease, liver disease, 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.

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.

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