Migranal

What you should know before using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatrics

There is no specific information comparing use of nasal dihydroergotamine in children with use in other age groups.

Geriatric

There is no specific information comparing use of nasal dihydroergotamine in older adults with use in other age groups.

Breast Feeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Drug Interactions

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Almotriptan
• Amprenavir
• Atazanavir
• Azithromycin
• Clarithromycin
• Clotrimazole
• Cocaine
• Darunavir
• Delavirdine
• Dirithromycin
• Efavirenz
• Epinephrine
• Erythromycin
• Fluconazole
• Fluoxetine
• Fluvoxamine
• Fosamprenavir
• Frovatriptan
• Indinavir
• Itraconazole
• Josamycin
• Ketoconazole
• Lidocaine
• Lopinavir
• Mepartricin
• Metronidazole
• Midodrine
• Miokamycin
• Naratriptan
• Nefazodone
• Nelfinavir
• Norepinephrine
• Phenylpropanolamine
• Posaconazole
• Propylhexedrine
• Pseudoephedrine
• Ritonavir
• Rizatriptan
• Rokitamycin
• Roxithromycin
• Saquinavir
• Saralasin
• Spiramycin
• Sumatriptan
• Tipranavir
• Troleandomycin
• Voriconazole
• Zileuton
• Zolmitriptan

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is not recommended. Your doctor may decide not to treat you with this medication, change some of the other medicines you take, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Heart or blood vessel disease or
• Hypertension (high blood pressure) or
• Kidney disease or
• Liver disease or
• Infection—The chance of serious side effects caused by nasal dihydroergotmine may be increased. Heart or blood vessel disease and high blood pressure sometimes do not cause any symptoms, so some people do not know that they have these problems. Before deciding whether you should use nasal dihydroergotamine, your doctor may need to do some tests to make sure that you do not have any of these conditions.