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Dihydroergotamine (DHE)

Brand names: Trudhesa, Migranal, D.H.E. 45

DHE treats migraine attacks, including long-lasting ones, as a nasal spray or shot.

Brand namesTrudhesa, Migranal, D.H.E. 45
Type of medicineErgot (migraine medicine)
Prescription?Prescription
ImportantThis page is general information, not a prescription. Don't start, stop, or change a medicine without talking to your provider or pharmacist.

Overview

It's useful when triptans don't work.

What it's used for

  • Migraine attacks
  • Cluster headaches

How to take it

  • Use at the first sign of a migraine, as directed.

Your dose depends on your health and other medicines. Always follow your prescription label, and ask your pharmacist if anything is unclear.

Side effects

Common side effects

  • Nausea
  • Stuffy nose (spray)
  • Tingling
Call 911Chest pain, or cold, numb, or blue fingers or toes
Call 911Sudden weakness, trouble speaking, or a severe headache

Warnings

  • Boxed warning: dangerous narrowing of blood vessels with strong CYP3A4 blockers.
  • Not for people with heart disease or uncontrolled high blood pressure.

Other medicines, foods, and alcohol

  • Never combine with ritonavir, clarithromycin, or ketoconazole.
  • Don't use within 24 hours of a triptan.

Tell your provider and pharmacist about every medicine, vitamin, and supplement you take.

Pregnancy and breastfeeding

Not used in pregnancy.

Missed doses, overdose, and storage

If you miss a dose

This medicine is often taken only when needed. If you take it on a schedule, take a missed dose when you remember, unless it's almost time for the next one. Don't double up.

If someone takes too much

Call Poison Control at 1-800-222-1222 or get help online at poison.org. Call 911 if the person collapses, has a seizure, has trouble breathing, or can't be woken.

Storing it

Store at room temperature, away from heat and moisture (not in the bathroom), and out of reach of children and pets.

Conditions it's used for

Sources

Last updated 2026-11-13.