Ergotamine tartrate

Ergotamine, an ergot alkaloid, mediates its acute anti-migraine effects primarily through agonist actions at 5-HT1B/1D serotonin receptors. This leads to vasoconstriction that can last for 24 hours or longer and is cumulative with repeated use. The drug also directly stimulates central nervous system emetic centers and gastrointestinal serotonin receptors, which contributes to common gastrointestinal side effects.

Adult

For acute migraine, 2 mg sublingually, repeated at 30-minute intervals if necessary. For very severe attacks, 0.25–0.5 mg intravenously or intramuscularly.

Max dose

6 mg in a 24-hour period (oral/sublingual); 10 mg per week (oral/sublingual).