Ergotamine
Ergotamine is a potent ergot alkaloid medication used primarily for the acute treatment of migraine and cluster headaches. It works by constricting expanded blood vessels in the head that are associated with headache pain. This medication is typically used when standard pain relievers are ineffective and should not be used for migraine prevention.
Ergotamine is a migraine and cluster headache treatment that relieves pain by narrowing blood vessels in the brain.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- N02CA02
- RxNorm
- 4025
- Generic
- Ergotamine
- Class
- atc-n02
- Brands
- Cafergot, Ergomar, Migergot
- Availability
- rx
- Lactation
- unknown
- Routes
- oral, rectal, sublingual
- Forms
- tablet
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 1-2mg at onset of migraine, may repeat 1mg after 30 minutes if needed
- Maximum
- consult physician
- Frequency
- not to exceed 6mg in 24 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- Not recommended for use in pediatric patients
- Maximum
- consult physician
- Frequency
- N/A
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 1mg at onset, use with extreme caution due to cardiovascular risks
- Maximum
- consult physician
- Frequency
- not to exceed 6mg in 24 hours, avoid in patients with cardiovascular disease
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
6 groupspregnancy
all trimestersavoid use completely
do not use ergotamine during pregnancy due to risk of uterine contractions, placental vasoconstriction, and fetal harm; consider alternative migraine treatments such as acetaminophen
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
lactation
breastfeedingavoid use
ergotamine is excreted in breast milk; do not breastfeed during treatment and for at least 24 hours after last dose; consider pumping and discarding breast milk
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
geriatric
elderly over 65reduce initial dose and titrate slowly
use lowest effective dose; increased sensitivity to cardiovascular effects; monitor blood pressure and for signs of ischemia; avoid in patients with coronary artery disease
regular cardiovascular monitoring including blood pressure and heart rate
Use with caution and monitor for adverse effects.
pediatric_age
adolescents under 18not recommended
ergotamine is not recommended for use in patients under 18 years of age due to safety concerns
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
renal_impairment
moderate to severereduce dose or increase dosing interval
use with caution in patients with renal impairment; may require dose reduction; avoid in severe renal impairment; monitor for signs of ergotism
monitor renal function and for signs of toxicity
Use with caution and monitor for adverse effects.
hepatic_impairment
moderate to severereduce dose
ergotamine is metabolized by the liver; use with caution in hepatic impairment; avoid in severe hepatic disease; consider dose reduction
monitor liver function and for signs of ergot toxicity
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA approval year
First FDA approval for Ergotamine/Cafergot
Drug class
ATC classification N02CA01
Common uses
Treatment of acute migraine and cluster headache attacks
Mechanism of action
5-HT1B/1D receptor agonist causing cranial vessel vasoconstriction
Ergotamine is indicated for the acute treatment of moderate to severe migraine headaches and cluster headaches. It is specifically designed for episodic use rather than preventive treatment and is generally reserved for patients who do not respond adequately to other headache medications.
Ergotamine acts as a partial agonist at serotonin, dopamine, and noradrenaline receptors, causing constriction of cranial blood vessels. This vasoconstriction reduces the pulsation of dilated cerebral blood vessels that contribute to migraine pain.
This medication carries significant risks including potential for vasoconstriction affecting other body areas and should be avoided in patients with cardiovascular disease, uncontrolled hypertension, or during pregnancy. Ergotamine can cause medication overuse headaches with frequent use and has multiple drug interactions.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy