If you’re using clarithromycin (Biaxin), erythromycin (E.E.S., E-Mycin, Erythrocin), caffeine, HIV protease inhibitors like indinavir (Crixivan), nelfinavir (Viracept), or ritonavir (Norvir), troleandomycin, or antifungals like itraconazole (Sporanox) and ketoconazole (N (TAO).

Ergotamine and caffeine are combined to both prevent and treat migraine headaches. Ergotamine belongs to the group of drugs known as ergot alkaloids. Along with coffee, it prevents headaches by limiting the growth of blood vessels in the head.

Ergotamine and caffeine are available as tablets to swallow or as suppositories to put rectally. It is typically given as soon as a migraine headache appears. Ask your doctor or chemist to explain any instructions on your prescription label that you are unsure about following. Take the prescribed dosages of both ergotamine and caffeine. Never take it in larger or less amounts or more frequently than directed by your doctor.

Follow these steps to use the tablets:

1. At the first sign of a migraine, take two pills.
2. Lay down and unwind for at least two hours in a silent, dark environment.
3. Take one or two extra pills if the headache discomfort does not go away in 30 minutes.
4. Unless the headache discomfort stops or six tablets have been consumed, take one or two every 30 minutes.
5. After taking six tablets, if the headache pain persists, call your doctor. Unless your doctor specifically instructs you to take more than six tablets for a headache, do not exceed this amount.
6. Never consume more than six pills in a 24-hour period or ten pills in a week. Call your doctor if you require more.

Follow these steps to utilise the suppositories:

1. Before removing the foil wrapping, place the suppository in ice cold water if it seems soft and wait until it solidifies.
2. Take off the package and moisten the suppository’s tip.
3. Raise your right knee to your chest while lying on your left side. (If you are left-handed, you should lie on your right side and lift your left leg.)
4. Using your finger, place the suppository in the rectum at a distance of 1 inch (2.5 centimetres) for adults and 1/2 to 1 inch (1.25 to 2.5 centimetres) for children. Keep it there for a short while.
5. Cleanse your hands well, then relax for at least two hours in a silent, dark place.
6. Use another suppository if the headache discomfort does not go away in an hour.
7. Call your doctor if your headache discomfort persists after you have placed two suppositories. Unless as directed by your doctor, never use more than two suppositories for a single headache.
8. In a week, don’t use more than five suppositories. Call your doctor if you require more.

Ask your doctor or chemist for more details if you believe this drug should be used for something else.

Before taking ergotamine and caffeine,

• If you have a caffeine, ergotamine, or any other pharmaceutical allergy, let your doctor and chemist know right away.
• Inform your physician and chemist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you are using. Mention the drugs in the IMPORTANT CAUTION section as well as any of the following: Clotrimazole, fluoxetine (Prozac, Sarafem), fluconazole (Diflucan), and fluvoxamine (Luvox), metronidazole (Flagyl), nefazodone (Serzone), propranolol (Inderal), saquinavir (Invirase, Fortovase), and zileuton are examples of drugs for asthma and colds (Zyflo). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• Inform your physician if you currently or ever had high blood pressure, circulatory issues, coronary artery disease, a serious blood infection, renal illness, or liver disease.
• Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor right away if you get pregnant while taking ergotamine and caffeine. Caffeine and ergotamine may be harmful to the foetus.

If you plan to consume grapefruit juice while taking this medication, consult your doctor.

Both caffeine and ergotamine may have negative effects. If any of these symptoms are severe or do not go away, consult your doctor right once:

• Nausea
• Vomiting

Some adverse effects may be severe. Although the following signs are unusual, if you notice any of them, consult your doctor right away:

• Leg trembling
• Chest ache
• Quick heartbeat
• Sluggish heartbeat
• Dizziness
• Muscles in the arms or legs hurt
• Blue fingers and toes
• Swelling
• Itching
• Tingling, burning, or discomfort in the toes and fingers

Caffeine and ergotamine may also have other adverse effects. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Keep it at ambient temperature and shield it from light, too much heat, and moisture (not in the bathroom).

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your chemist or the garbage/recycling agency in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose symptoms could include:

• Vomiting
• Numbness
• Tingling feeling
• Pain
• Blue fingers and toes
• Absence of pulse
• Feeling unsteady or lightheaded
• Fainting
• Drowsiness
• Unconsciousness
• Coma
• Seizures

Keep all of your doctor’s appointments.

If you use this drug in high quantities for an extended period of time, you can experience a severe headache for a few days after quitting it. Call your doctor if the headache persists for more than a few days.

No one else should take your medication. Any queries you may have regarding prescription refills should be directed to your chemist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.