Dihydroergotamine Mesylate 4 mg/mL Suppliers & Bulk Manufacturers

Available Forms: Nasal Spray

Available Strengths: 4 mg/mL

Reference Brands: Migranal (USA/EU)

Category: Neurology

Dihydroergotamine is an ergot alkaloid used to treat acute migraine attacks and cluster headaches. It works by constricting blood vessels in the brain and reducing inflammation around cranial nerves, which helps relieve migraine symptoms.

Product Description:

Dihydroergotamine is a hydrogenated ergot alkaloid with broad receptor activity: agonism at 5-HT1B/1D/1F, plus adrenergic and dopaminergic effects. Compared with ergotamine it is a weaker arterial constrictor and a stronger venoconstrictor, which gives it a better cardiovascular margin. Its clinical value in migraine is a long duration of action and a low headache recurrence rate, and it can work late in an attack when triptans have failed.

The nasal spray avoids injection and the poor, erratic oral bioavailability that made oral forms unreliable; it is primed and given as one spray in each nostril, repeated after fifteen minutes. Nausea is less of a problem than with ergotamine. The critical safety issue is a boxed warning: combined with strong CYP3A4 inhibitors — macrolide antibiotics, azole antifungals, HIV protease inhibitors — it can cause serious peripheral and cerebral ischaemia. It must not be given within twenty-four hours of a triptan.

Sourcing notes. The spray is a device-drug combination, so the metering pump, spray pattern and droplet size are part of the specification and of any bioequivalence case, not just the solution. The solution is light-sensitive and packed in amber vials. Registration of intranasal DHE is limited; many markets register only the injection. Ergot derivatives also attract precursor-chemical scrutiny in some jurisdictions.