Article: Cafergot

Cafergot is the proprietary name of a medication consisting of ergotamine tartrate or ergoline and caffeine. This combination is used for the treatment of vascular headaches, such as migraine headache.

The molecular structure of ergotamine

The molecular structure of caffeine

Use

Correct timing of use is important. Cafergot is an abortive headache treatment, which prevents the development of the headache, rather than a treatment for an established headache. The medication should be administered at the first sign of headache.

Mechanism of action

Dilated blood vessels cause higher intracranial pressure, which causes migraine headache. Ergotamine tartrate and caffeine both are vasoconstrictors, that is substances which act to constrict blood vessels, and thus reduce pressure on the brain, relieving the headache.

Adverse effects

Because the vasoconstrictive effects of ergotamine and caffeine are not selective for the brain, adverse effects due to systemic vasoconstiction can occur. Cold feet or hands, angina pectoris or dizziness are some examples.

Ergotamine, if used frequently over a prolonged period of time, can cause dependence in the patient. If dependence occurs then cessation of ergotamine use can precipitate the same headaches which the drug was being used to treat. For this reason frequency of use must be restricted.

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