GENERIC NAME: METHYSERGIDE - ORAL (meth-eh-SER-jide)
WARNING: When used for an extended time, methysergide has infrequently caused abnormal thickening of heart valves and of the lining of the lungs/abdomen. Therefore, methysergide should be used only when the headaches are frequent and severe. Patients must be under close medical supervision.
USES: This medication is used to prevent or decrease the pain/frequency of certain severe recurring headaches (vascular headaches such as migraine headaches and cluster headaches). Because of possible serious side effects, it is used after other treatments (e.g., beta blockers) have not worked.Methysergide is an ergot alkaloid. It is thought to work by narrowing blood vessels in the head, thereby reducing the throbbing effects of vascular headaches. Methysergide is not used to treat migraine attacks when they occur.
HOW TO USE: When starting this medication, take it at night with food or milk to prevent stomach upset. As your doctor increases your dose, this medication is usually taken 2 to 3 times a day with meals. Your dosage depends on your condition and response to treatment.Your doctor may direct you to take a low dose at first, gradually increasing the dose to lower the chance of side effects such as nausea. Your doctor will adjust your dose to find the best dose for you. Follow your doctor's directions carefully. The usual maximum dose for adults is 12 milligrams of methysergide each day.Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day. If you are using this medication for headaches that occur in groups for periods of time (cluster headaches), it is usually taken only during the cluster and stopped after the cluster is over. Follow your doctor's directions carefully.Very serious side effects may occur when methysergide is taken continuously for a long time. Do not take methysergide for more than 6 months in a row. (See also Warning section.) This medication is for prevention. Do not use this medication to treat a current headache.Do not stop taking this medication without consulting your doctor. Your headaches may become worse ("rebound headache") when the drug is suddenly stopped. Your doctor will direct you to stop taking the medication by gradually lowering your dose over 2 to 3 weeks. After properly stopping the medication, do not take it again for 3 to 4 weeks as directed by your doctor.Methysergide usually starts to work in 1 to 2 days. Tell your doctor if your condition persists or worsens after 3 weeks.
SIDE EFFECTS: Nausea, vomiting, diarrhea, dizziness, drowsiness, stomach upset, heartburn, trouble sleeping, and flushing may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but very serious side effects occur: dizziness (especially upon standing), tingling/pain/coldness in the fingers/toes, whitish fingers/toes/nails, loss of feeling in the fingers/toes, bluish hands/feet, muscle pain/weakness, unusual weight gain.Seek immediate medical attention if any of these rare but very serious side effects occur: vision changes, confusion, slurred speech.A very serious scarring/thickening of the lining in the lungs, around the heart, and in the abdomen/pelvis may occur. Stop taking methysergide and tell your doctor immediately if any of these effects occur: shortness of breath, tightness/pain in the chest, slow/fast/irregular heartbeat, lower back pain, leg cramps, pain/redness/swelling of the legs/feet, severe stomach/abdominal pain, change in the amount/color of urine, difficult/painful urination, unusual weakness/tiredness.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, tell your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to methysergide; or to other ergot alkaloids (e.g., methylergonovine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: autoimmune disease (e.g., rheumatoid arthritis), blood vessel disease (e.g., peripheral vascular disease, hardening/inflammation of the arteries, blood clots, Raynaud's disease, stroke), uncontrolled high blood pressure, heart disease (e.g., coronary artery disease, heart attack, heart valve problems), scarring caused by a drug (e.g., retroperitoneal fibrosis), severe infection (e.g., cellulitis of the legs/feet, sepsis), severe liver disease, certain lung disease (pulmonary fibrosis), severe kidney disease, certain types of migraine (hemiplegic or basilar migraine), nutrient deficiency (malnutrition), urinary blockage.Before using this medication, tell your doctor or pharmacist your medical history, especially of: smoking, diabetes, high blood pressure (controlled), stomach/intestinal ulcers.This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. Remember that alcohol may cause headaches.Smoking can make headaches worse. Do not smoke.This medication is not recommended for use in children because of the risk of scarring (fibrosis).This medication may harm an unborn baby. Therefore, it must not be used during pregnancy. It is recommended that women use 2 effective forms of birth control (e.g., condoms, birth control pills) while taking this medication. If you become pregnant or think you may be pregnant, tell your doctor immediately. Consult your doctor for more details and to discuss reliable forms of birth control.This drug may pass into breast milk and could have undesirable effects on a nursing infant. Therefore, breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.
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DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.This drug should not be used with the following medications because very serious interactions may occur: drugs affecting liver enzymes that remove methysergide from your body (e.g., azole antifungals such as ketoconazole, itraconazole, voriconazole, macrolide antibiotics such as erythromycin, clarithromycin, HIV drugs such as delavirdine, efavirenz, indinavir, nelfinavir, ritonavir), other ergot alkaloids (e.g., ergonovine), smoking/nicotine products (e.g., patches, gum), sibutramine.If you also take "triptan" migraine drugs (e.g., sumatriptan, rizatriptan), you will need to separate your "triptan" dose from your dose of this medication to reduce the risk of serious side effects. Ask your doctor how long you should wait between your doses of these drugs.If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting this medication.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially: drugs for diabetes (e.g., insulin, tolbutamide), nitrates (e.g., isosorbide, nitroglycerin), SSRI antidepressants (e.g., fluoxetine, fluvoxamine).Check the labels on all your medicines (e.g., cough-and-cold products, diet aids, other migraine medications) because they may contain ingredients that could increase your heart rate or blood pressure. Ask your pharmacist about the safe use of those products.This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: mental/mood changes, hyperactivity, sweating, rapid heartbeat, blue/cold arms, hands, legs, and feet.
NOTES: Do not share this medication with others.Certain foods/beverages or food additives (e.g., red wine, cheese, chocolate, monosodium glutamate, alcohol) as well as some lifestyle patterns (e.g., irregular eating/sleeping habits, stress) may cause a migraine headache. Avoiding these "triggers" may help decrease the frequency of migraine headaches. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
STORAGE: Store at room temperature away from sunlight and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
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