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Ergotamine Tartrate (By mouth)

Treats migraine or cluster headaches. Belongs to a class of drugs called ergot alkaloids.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Brand names include
Ergomar
Drug classes About this
Antimigraine

What works? Research summarized

Evidence reviews

Sumatriptan (rectal route of administration) for acute migraine attacks in adults

Sumatriptan is one of the triptan family of drugs used to treat migraine attacks. It is available as a rectal suppository in some countries, and this route of administration may be preferable for individuals experiencing nausea and/or vomiting. This review found that a single dose administered rectally was effective in relieving migraine headache pain and functional disability. Pain was reduced from moderate or severe to no pain by two hours in approximately 2 in 5 people (41%) taking sumatriptan 25 mg, compared with about 1 in 6 (17%) taking placebo. Pain was reduced from moderate or severe to no worse than mild pain by two hours in roughly 2 in 3 people (71%) taking sumatriptan 25 mg, compared with approximately 1 in 3 (30%) taking placebo. In addition to relieving headache pain, sumatriptan 25 mg also relieved functional disability by two hours in about 2 in 5 people (41%), compared with about 1 in 6 (16%) taking placebo. There was not enough evidence to draw any conclusions about the incidence of adverse events or to compare rectal sumatriptan directly with any other active comparators.

Drug Class Review: Agents for Overactive Bladder: Final Report Update 4 [Internet]

Overactive bladder is defined by the International Continence Society as a syndrome of urinary frequency and urgency, with or without urge incontinence, appearing in the absence of local pathological factors. Treatment of overactive bladder syndrome first requires a clear diagnosis. In patients with incontinence, multiple forms can be present and it is important to determine which form is dominant. Non-pharmacologic, non-surgical treatment consists of behavioral training (prompted voiding, bladder training, pelvic muscle rehabilitation), transcutaneous electrical nerve stimulation, catheterization, and use of absorbent pads. Pharmacologic treatment for overactive bladder syndrome includes darifenacin, flavoxate hydrochloride, hyoscyamine, oxybutynin chloride, tolterodine tartrate, trospium chloride, scopolamine transdermal, and solifenacin succinate. The purpose of this systematic review is to compare the benefits and harms of drugs used to treat overactive bladder syndrome.

Drug Class Review: Beta Adrenergic Blockers: Final Report Update 4 [Internet]

Beta blockers inhibit the chronotropic, inotropic, and vasoconstrictor responses to the catecholamines, epinephrine, and norepinephrine. Beta blockers differ in their duration of effect (3 hours to 22 hours), the types of beta receptors they block (β1-selective or β1/β2-nonselective), whether they are simultaneously capable of exerting low level heart rate increases (intrinsic sympathomimetic activity [ISA]), and in whether they provide additional blood vessel dilation effects by also blocking alpha-1 receptors. All beta blockers are approved for the treatment of hypertension. Other US Food and Drug Administration-approved uses are specific to each beta blocker and include stable and unstable angina, atrial arrhythmias, bleeding esophageal varices, coronary artery disease, asymptomatic and symptomatic heart failure, migraine, and secondary prevention of post-myocardial infarction. The objective of this review was to evaluate the comparative effectiveness and harms of beta blockers in adult patients with hypertension, angina, coronary artery bypass graft, recent myocardial infarction, heart failure, atrial arrhythmia, migraine or bleeding esophageal varices.

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Summaries for consumers

Sumatriptan (rectal route of administration) for acute migraine attacks in adults

Sumatriptan is one of the triptan family of drugs used to treat migraine attacks. It is available as a rectal suppository in some countries, and this route of administration may be preferable for individuals experiencing nausea and/or vomiting. This review found that a single dose administered rectally was effective in relieving migraine headache pain and functional disability. Pain was reduced from moderate or severe to no pain by two hours in approximately 2 in 5 people (41%) taking sumatriptan 25 mg, compared with about 1 in 6 (17%) taking placebo. Pain was reduced from moderate or severe to no worse than mild pain by two hours in roughly 2 in 3 people (71%) taking sumatriptan 25 mg, compared with approximately 1 in 3 (30%) taking placebo. In addition to relieving headache pain, sumatriptan 25 mg also relieved functional disability by two hours in about 2 in 5 people (41%), compared with about 1 in 6 (16%) taking placebo. There was not enough evidence to draw any conclusions about the incidence of adverse events or to compare rectal sumatriptan directly with any other active comparators.

Treating migraine with medication

Migraine attacks can be treated with different types of medication. Apart from commonly used painkillers, products for nausea or special migraine medication called triptans can also be used.Most people will use one or more medications to help them through an attack, especially if the migraine is very painful. Which medications people use depends on how serious the migraine attack is: A "basic" painkiller from a pharmacy might be enough to relieve moderate pain. But a stronger medication is needed for more severe migraines. People who have frequent migraines will often keep a variety of medications ready to be used if needed.The types of medication most commonly used by adults with migraines are:Painkillers from the group of non-steroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid (ASA, the drug in "Aspirin"), ibuprofen, diclofenac or naproxen, and acetaminophen (paracetamol)Nausea medication like metoclopramide or domperidoneSpecial migraine medication (triptans) such as almotriptan or eletriptanAnother substance some migraine prescription drugs are based on  is ergotamine, which is derived from a grain fungus called ergot. For almost a century this was the only medicine specifically used to treat migraines. Nowadays, ergotamine is used less because it has more side effects than the triptans. In Germany, ergotamine products are no longer approved for preventing migraines as of 2014.Different types of medication serve different purposes. Some people mainly want relief as quickly as possible. They might go for a drug that acts faster, even if another might provide more relief but take longer to kick in. For others, maximum relief is the most important thing, even if it takes a little longer to start working. People whose migraines last for a long time might prefer drugs with a longer-lasting effect. Some people's options are limited, for example because they have heart disease and are therefore advised not to use triptans.

Prophylactic interventions after delivery of placenta for reducing bleeding during the postnatal period

Haemorrhage following childbirth (postpartum haemorrhage) is a major cause of maternal death and health problems in resource‐poor settings in both low‐ and high‐income countries. Postpartum haemorrhage is defined as blood loss from the genital tract of more than 500 mL, generally occurring within the first 24 hours after delivering the placenta and occasionally between 24 hours and six to 12 weeks. Possible causes are the uterus (womb) failing to contract after delivery (uterine atony), a retained placenta, inverted or ruptured uterus, and cervical, vaginal, or perineal lacerations. To address these issues, the joint policy statements between the International Confederation of Midwives, the International Federation of Gynecology and Obstetrics, and the World Health Organization recommend 'active management of third stage of labour', which includes the administration of a uterotonic drug (intravenous oxytocin), just before or just after delivery in order to help the uterine muscles to contract. The use of oral uterotonic drugs such as methylergometrine for the prevention of postpartum haemorrhage after delivery of the placenta is not recommended in the joint policy statements. Yet orally delivered uterotonic drugs, such as ergot alkaloids (including methylergometrine), herbal therapies, or homeopathic remedies are easy‐to‐administer agents that may be considered as possible alternatives after delivery of the placenta in developing countries, as in Japan. We set out to determine whether such agents are effective in preventing haemorrhage after childbirth. We found a total of five randomised clinical trials (involving 1466 women). In three of the trials (involving 1268 women), oral methylergometrine was compared with placebo (two trials) or the Japanese traditional herbal medicine Kyuki‐chouketsu‐in (one trial). The other two trials (involving 198 women) did not report information on relevant outcomes of interest for this review. Overall, there was no clear evidence that prophylactic oral methylergometrine was effective in reducing haemorrhage after childbirth. The trials were not of good quality and adverse events were not well‐reported. We did not find any completed trials looking at the effectiveness of homeopathic remedies in reducing haemorrhage after childbirth. The effectiveness of such remedies warrants further investigation.

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