What is Degran?
Degran is a combination medicine that contains ergotamine and caffeine. It is used in the treatment of migraine and other vascular headaches. A vascular headache, or migraine, refers to a group of headache conditions that occur due to changes in blood vessels in the head or neck. They often involve throbbing pain and swelling or dilation of the blood vessels.
Ergotamine is in a class of medications called ergot alkaloids. It works together with caffeine by preventing blood vessels in the head from expanding and causing headaches.
The formulation (Ergotamine &caffeine) also known as ergotamine tartrate, is FDA approved to terminate or prevent vascular headaches such as migraines, variations of migraines, or cluster headaches.
Degran is for use in patients with more severe symptoms and whose migraines have not responded to NSAIDs or combination analgesics.
How should Degran be used?
Degran comes as a tablet to take by mouth and as a suppository to insert rectally. It is usually taken at the first sign of a migraine headache. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Degran exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
To use the tablets, follow these steps:
1. Take two tablets at the first sign of a migraine.
2. Lie down and relax in a quiet, dark room for at least 2 hours.
3. If the headache pain does not stop within 30 minutes, take one or two more tablets.
4. Take one or two tablets every 30 minutes until the headache pain stops or you have taken six tablets.
5. If the headache pain continues after you have taken six tablets, call your doctor. Do not take more than six tablets for one headache unless your doctor specifically tells you to do so.
6. Do not take more than six tablets in 24 hours or 10 tablets in 1 week. If you need more, call your doctor.
To use the suppositories, follow these steps:
1. If the suppository feels soft, place it in ice-cold water (before removing the foil wrapper) until it hardens.
2. Remove the wrapper and dip the tip of the suppository in water.
3. Lie down on your left side and raise your right knee to your chest. (A left-handed person should lie on the right side and raise the left knee.)
4. Using your finger, insert the suppository into the rectum, about 1/2 to 1 inch (1.25 to 2.5 centimeters) in children and 1 inch (2.5 centimeters) in adults. Hold it in place for a few moments.
5. Wash your hands thoroughly; then lie down and relax in a dark, quiet room for at least 2 hours.
6. If the headache pain does not stop within 1 hour, insert another suppository.
7. If the headache pain continues after you have inserted two suppositories, call your doctor. Do not use more than two suppositories for one headache unless your doctor specifically tells you to do so.
8. Do not use more than five suppositories in 1 week. If you need more, call your doctor.
Degran side effects
Common side effects of Degran include:
• numbness, tingling, burning pain;
• dizziness, spinning sensation;
• itching or swelling;
• nausea, vomiting; or
• (with suppository use) a rectal sore or ulcer.
Serious side effects of Degran include:
• severe pain in the stomach or back;
• bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• cramps in your hips or legs, leg pain or swelling;
• weak pulses in the arms and legs, numbness and tingling or pain in the hands or feet, blue-colored fingers or toes;
• muscle pain or weakness in the arms or legs;
• fast or slow heart rate;
• severe headache, blurred vision, pounding in the neck or ears;
• sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance; or
• painful sores on the rectum after using the rectal suppositories.
Rare side effects of Ergotamine/Caffeine include:
This is not a complete list of Degran side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.
Can a pregnant woman take Degran?
No, Degran should not be taken during pregnancy because it can cause harm when taken by a pregnant woman. It should not also be taken by women who plan to become pregnant.
Safe medications for migraine in pregnancy include acetaminophen, diphenhydramine, lidocaine SQ, metoclopramide, and nonsteroidal anti-inflammatory drugs — the latter of which can be safely used during the second trimester only. Your doctor or health care provider might recommend other medications as well. Make sure you have the OK from your health care provider before taking any medication, including herbal treatments.
Can a breastfeeding woman take Degran?
No, Degran can pass from a mother’s breast milk to a child and cause symptoms of vomiting, diarrhea, weak pulse, and unstable blood pressure in nursing infants. Breastfeeding mothers should not use Degran.
What drugs could interact with Degran?
There may be an interaction between Degran and any of the following:
• antifungal agents (e.g., ketoconazole, itraconazole)
• beta-blockers (e.g., propranolol, sotalol, timolol)
• macrolide antibiotics (e.g., erythromycin, clarithromycin, telithromycin)
• nitrates (e.g., nitroglycerin, isosorbide)
• other ergot medications (e.g., methysergide, dihydroergotamine, ergonovine, ergoloid mesylates)
• protease inhibitors (e.g., ritonavir, nelfinavir, indinavir)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.