Ergotamine/caffeine

Ergotamine/caffeine, sold under the brand name Cafergot among others, is a fixed-dose combination medication used for the treatment of migraine. It contains ergotamine, as the tartrate, an alpha adrenergic blocking agent; and caffeine, a cranial vasoconstrictor.^[3]

Ergotamine/caffeine

Combination of
Ergotamine	vasoconstrictor, neurotransmitter agonist and antagonist
Caffeine	vasoconstrictor, phosphodiesterase inhibitor
Clinical data
Trade names	Cafergot, Migergot, others
AHFS/Drugs.com	Multum Consumer Information
MedlinePlus	a601048
License data	US DailyMed: Ergotamine and caffeine
Pregnancy category	AU: C Contraindicated
Routes of administration	By mouth, rectal
ATC code	N02CA52 (WHO)
Legal status
Legal status	US: ℞-only[1][2]
Identifiers
CAS Number	69063-86-1
KEGG	D07600

Ergotamine/caffeine is available as a generic medication.

Medical uses

Ergotamine/caffeine is indicated as therapy to abort or prevent vascular headache.^[1][2]

Mechanism of action

Ergotamine binds to 5-HT_1B and 5-HT_1D receptors.^[4] This along with binding to other serotonergic and dopaminergic receptors is their presumed mechanism of action in treating migraine.^[4][5]

Adverse effects

Because the vasoconstrictive effects of ergotamine and caffeine are not selective for the brain, adverse effects due to systemic vasoconstriction can occur. Cold feet or hands, angina pectoris, myocardial infarction,^[6] or dizziness are some examples.

It has also been shown to be associated with mitral valve stenosis. ^[7]