D.H.E. 45
Cluster Headache, Migraine Disorders
Treatment
3 Active Studies for D.H.E. 45
Treatment for
Cluster Headache
What is D.H.E. 45
Dihydroergotamine
The Generic name of this drug
Treatment Summary
Dihydroergotamine is a medication used to treat migraines. It is not as commonly used as other medications like triptans because it has more side effects. Recent advancements in nasal delivery systems have improved the use of dihydroergotamine, increasing the amount of the drug that reaches the bloodstream. Impel Neuropharma recently developed a new delivery system, Precision Olfactory Delivery, which has been shown to increase the amount of dihydroergotamine in the bloodstream by three times.
Migranal
is the brand name
D.H.E. 45 Overview & Background
Brand Name
Generic Name
First FDA Approval
How many FDA approvals?
Migranal
Dihydroergotamine
1997
21
Effectiveness
How D.H.E. 45 Affects Patients
DHE is used to treat migraine headaches with or without an aura, as well as cluster headache episodes. It works by activating serotonin, which can reduce the amount of glutamate in the brain and help prevent migraine headaches. It also causes blood vessels to narrow, which can help reduce migraine pain and cause the side effect of chest tightness.
How D.H.E. 45 works in the body
DHE is believed to treat migraines in multiple ways. One way is by constricting the blood vessels that become widened during a migraine. It also blocks pain signals between the thalamus and trigeminal nerve in the brain, and reduces inflammation and pain in the trigeminal nerve. DHE has 10 times less potency than ergotamine so it is less likely to cause vascular side effects. It is difficult to predict how long its effects will last because it takes time for it to diffuse from receptors in the body.
When to interrupt dosage
The dose of D.H.E. 45 is contingent upon the diagnosed affliction. The amount of dosage likewise differs as per the delivery technique (e.g. Intramuscular; Intravenous; Subcutaneous or Spray, metered) featured in the ensuing table.
Condition
Dosage
Administration
Cluster Headache
, 1.0 mg/mL, 4.0 mg/mL, 2.5 mg, 0.5 mg/pump actuation
Intramuscular; Intravenous; Subcutaneous, , Injection, solution, Injection, solution - Intramuscular; Intravenous; Subcutaneous, Spray, Spray - Nasal, Nasal, Liquid, Liquid - Intramuscular; Intravenous; Subcutaneous, Liquid - Nasal, Tablet - Oral, Oral, Tablet, Injection - Intramuscular; Intravenous; Subcutaneous, Injection, Spray, metered, Spray, metered - Nasal
Migraine Disorders
, 1.0 mg/mL, 4.0 mg/mL, 2.5 mg, 0.5 mg/pump actuation
Intramuscular; Intravenous; Subcutaneous, , Injection, solution, Injection, solution - Intramuscular; Intravenous; Subcutaneous, Spray, Spray - Nasal, Nasal, Liquid, Liquid - Intramuscular; Intravenous; Subcutaneous, Liquid - Nasal, Tablet - Oral, Oral, Tablet, Injection - Intramuscular; Intravenous; Subcutaneous, Injection, Spray, metered, Spray, metered - Nasal
Warnings
D.H.E. 45 has nineteen contraindications, and should thus be abstained from if any of the conditions in the ensuing table are encountered.
D.H.E. 45 Contraindications
Condition
Risk Level
Notes
Coronary Vasospasm
Do Not Combine
Pulse Frequency
Do Not Combine
Pulse Frequency
Do Not Combine
Chest Pain
Do Not Combine
Pulse Frequency
Do Not Combine
Documented Silent Ischemia
Do Not Combine
Severe Hepatic Impairment
Do Not Combine
Renal Insufficiency
Do Not Combine
Migraine with Aura
Do Not Combine
Hypertensive disease
Do Not Combine
Liver Failure
Do Not Combine
Hemiplegic migraine
Do Not Combine
Vasospastic Angina
Do Not Combine
Women who are breast-feeding or pregnant
Do Not Combine
Vascular Surgery
Do Not Combine
Peripheral Arterial Disease
Do Not Combine
Pulse Frequency
Do Not Combine
Coronary Artery Disease
Do Not Combine
Severe Hypersensitivity Reactions
Do Not Combine
Dihydroergotamine may interact with Pulse Frequency
There are 20 known major drug interactions with D.H.E. 45.
Common D.H.E. 45 Drug Interactions
Drug Name
Risk Level
Description
4-Bromo-2,5-dimethoxyphenethylamine
Major
Dihydroergotamine may increase the hypertensive and vasoconstricting activities of 4-Bromo-2,5-dimethoxyphenethylamine.
4-Methoxyamphetamine
Major
Dihydroergotamine may increase the hypertensive and vasoconstricting activities of 4-Methoxyamphetamine.
5-methoxy-N,N-dimethyltryptamine
Major
Dihydroergotamine may increase the vasoconstricting activities of 5-methoxy-N,N-dimethyltryptamine.
Abediterol
Major
Dihydroergotamine may increase the hypertensive and vasoconstricting activities of Abediterol.
Abemaciclib
Major
The metabolism of Abemaciclib can be decreased when combined with Dihydroergotamine.
D.H.E. 45 Toxicity & Overdose Risk
Overdosing on ergot may lead to numbness, tingling, and pain in the extremities, difficulty breathing, fluctuations in blood pressure, mental confusion, seizures, coma, nausea, vomiting, and abdominal pain. In case of overdose, affected areas should be warmed and vasodilators administered. Contact local poison control centres for more detailed instructions on how to treat ergot overdose.
D.H.E. 45 Novel Uses: Which Conditions Have a Clinical Trial Featuring D.H.E. 45?
A total of 7 active studies are investigating the potential of D.H.E. 45 to alleviate symptoms of Cluster Headache.
Condition
Clinical Trials
Trial Phases
Migraine Disorders
1 Actively Recruiting
Not Applicable
Cluster Headache
2 Actively Recruiting
Phase 1, Phase 2
D.H.E. 45 Reviews: What are patients saying about D.H.E. 45?
5
Patient Review
5/26/2010
D.H.E. 45 for Migraine Headache
5
Patient Review
11/25/2008
D.H.E. 45 for Migraine Headache
5
Patient Review
1/10/2009
D.H.E. 45 for Migraine Headache
4.7
Patient Review
9/18/2010
D.H.E. 45 for Migraine Headache
4
Patient Review
10/10/2011
D.H.E. 45 for Cluster Headache
4
Patient Review
7/3/2010
D.H.E. 45 for Migraine Headache
1.7
Patient Review
3/7/2011
D.H.E. 45 for Migraine Headache
1
Patient Review
1/26/2015
D.H.E. 45 for Migraine Headache
Patient Q&A Section about d.h.e. 45
These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.
How does DHE make you feel?
"The following are side effects that may occur when taking the medication: dizziness, drowsiness, headache, nausea, vomiting, diarrhea, flushing, increased sweating, anxiety, or skin rash."
Answered by AI
What is a DHE injection?
"D.H.E. 45 should only be used to treat an active migraine headache. Do not use it to prevent a headache if you have no symptoms and do not use it to treat a tension headache that is not typical of your usual migraine headache."
Answered by AI
How long does DHE infusion last?
"The original protocol for treating migraines called for administering a dose of 0.3-1 mg of DHE every 8 hours, along with 10 mg of metoclopramide for 2-3 days."
Answered by AI
How does DHE work for migraines?
"Dihydroergotamine is a medication that attaches to pain receptors in the brain and nerves, changing how messages are sent back and forth. This changes the perception of pain in the brain. DHE does not 'cure' headaches but it should improve how often they occur and how severe they are."
Answered by AI