What is Migranal?

Migranal (dihydroergotamine mesylate) is a headache medicine that narrows blood vessels around the brain. Migranal is used to treat migraines with or without aura.

Migranal may also be used for purposes not listed in this medication guide.

Health Benefits

Migranal can help to relieve the symptoms of migraines, including pain, nausea, and sensitivity to light and sound. This medication may also help to prevent migraines from occurring.

Migranal is a prescription medication and is not available over-the-counter (OTC). It comes as an injection and is usually administered by a healthcare provider.

Migranal should not be used to treat a headache that is already occurring. It should only be used to prevent future migraines or to relieve the symptoms of an aura ( warning signs that a migraine is about to occur).

Side Effects

Common side effects of Migranal include:

drowsiness,

dizziness,

nausea,

vomiting,

diarrhea,

stomach pain or cramps,

flushing (warmth, redness, or tingly feeling), and/or

headaches.

Migranal may also cause serious side effects, including:

stroke,

heart attack, or

blood clotting.

Call your doctor immediately if you experience any of these serious side effects.

Dosage

The recommended dosage of Migranal for migraine prevention is 2-4mg injected under the skin once daily.

For the treatment of migraines, the recommended dose is 6-9mg injected under the skin at the first sign of a migraine. If necessary, a second dose may be administered after 30 minutes.

Migranal should not be used more than twice in a 24 hour period.

Interactions

Migranal may interact with other medications, including:

selective serotonin reuptake inhibitors (SSRIs),

triptans, and/or

ergot alkaloids.

Tell your doctor all medications you are taking. Migranal should not be used during pregnancy unless the benefits outweigh the risks. This medication may pass into breast milk and could have harmful effects on a nursing baby. Consult your doctor before breastfeeding.

Migranal is not recommended for use by people with certain medical conditions, including:

coronary artery disease,

uncontrolled high blood pressure,

history of stroke or blood clot,

history of heart attack, or

peripheral vascular disease.

Migranal may not be right for you if you have certain medical conditions. Be sure to tell your doctor if you have any other medical problems, especially:

asthma or allergies,

diabetes,

glaucoma,

high blood pressure,

history of heart disease or heart attack,

history of stroke or blood clot, or

kidney disease.

Mechanism of Action

Migranal works by narrowing blood vessels around the brain. This action helps to relieve the pain, nausea, and sensitivity to light and sound associated with migraines.

Migranal may also help to prevent migraines from occurring. It is not entirely clear how this medication works to prevent migraines.

Pharmacokinetics

Migranal is rapidly absorbed from the injection site and has an onset of action within 15 minutes. The peak effect occurs at 1-2 hours.

Migranal is metabolized in the liver and excreted in the urine.

Half-life: 3-4 hours

Protein binding: 95%

Volume of distribution: 0.85 L/kg

Clearance: 7.7 mL/min/kg

Alternatives to Migranal

There are many medications available to treat migraines. Some common migraine treatments include:

ibuprofen (Advil, Motrin),

naproxen (Aleve),

acetaminophen (Tylenol), and

aspirin.

These medications are available over-the-counter (OTC) and do not require a prescription. If OTC medications do not relieve your symptoms, your doctor may prescribe a stronger medication. Some common prescription migraine treatments include:

triptans, such as sumatriptan (Imitrex) and rizatriptan (Maxalt), and/or

ergot alkaloids, such as dihydroergotamine (D.H.E. 45) and ergometrine (Ergomar).

Your doctor will determine the best treatment for you based on your individual symptoms and medical history.

Chemistry

Migranal is a synthetic female hormone with the chemical name divalproex sodium. It has a molecular weight of 257.73 and the following chemical structure:

Migranal is available as a white to off-white powder for injection in 4mg/0.5mL, 8mg/1mL, and 16mg/2mL vials.

Storage

Migranal should be stored at room temperature, 15-30°C (59-86°F).

Do not freeze or refrigerate this medication. After mixing Migranal, it can be stored at room temperature for up to 24 hours or in the refrigerator for up to 48 hours.