Migranal (Dihydroergotamine Mesilate)

Dihydroergotamine mesylate, the active ingredient in Migranal, is an ergot alkaloid presented as a 1 mg per spray nasal spray for nasal use. It treats acute migraine attacks in adults. GNH USA supplies Migranal as a licensed, GDP-compliant international pharmaceutical supplier serving hospitals, pharmacies and clinics worldwide.

Migranal (dihydroergotamine mesylate) is used in the acute treatment of migraine, a neurovascular headache disorder.

Acute migraine attacks: provides rapid relief of headache pain and associated symptoms such as nausea and photophobia. Migraine with aura: helps abort the headache phase after aura onset. Status migrainosus: can be employed to terminate prolonged migraine episodes when other treatments have failed.

Common Side Effects: - Nasal irritation or burning sensation - Nausea or vomiting - Dizziness or light‑headedness - Dry mouth or altered taste - Fatigue or mild headache - Transient flushing

Serious or Rare Side Effects: - Severe hypertension or hypertensive crisis - Coronary or peripheral vasospasm leading to ischemia - Serotonin syndrome when combined with serotonergic agents - Allergic reactions including rash, angioedema, or anaphylaxis - Ergotism presenting with severe vasoconstriction and gangrene - Cardiac arrhythmias or myocardial infarction

Precautions should be observed before prescribing Migranal.

Pregnancy: safety not established; avoid unless benefits outweigh risks. Cardiovascular disease: contraindicated in uncontrolled hypertension, coronary artery disease, or peripheral vascular disease. Drug interactions: avoid concomitant use with potent vasoconstrictors or serotonergic agents. Renal/hepatic impairment: use with caution; dose adjustment may be required. Store at room temperature: keep in original container, protect from moisture and light.

Dihydroergotamine mesylate may interact with several drug classes.

Major Interactions (Avoid): - Ergotamine‑containing products: additive vasoconstriction risk. - SSRIs, SNRIs, or triptans: increased risk of serotonin syndrome and vasospasm. - Concomitant vasoconstrictors (e.g., phenylephrine): severe hypertension.

Moderate Interactions (Monitor Closely): - CYP3A4 inhibitors (e.g., ketoconazole): may raise dihydroergotamine plasma levels. - Antihypertensive agents: monitor blood pressure for additive effects.