Caffeine is a stimulant that causes narrowing of blood vessels (vasoconstriction). Ergotamine is an ergot alkaloid (ER-got AL-ka-loid) that works by narrowing blood vessels around the brain.

Caffeine and ergotamine is a combination medicine used to treat or prevent a migraine type headache.

This medication will only treat a headache that has already begun. It will not prevent migraine headaches or reduce the number of attacks.

Caffeine and ergotamine should not be used to treat common tension headaches or any headache that seems to be different from your usual migraine headaches.

Caffeine and ergotamine may also be used for purposes not listed in this medication guide.

You should not use this medicine if you are allergic to caffeine or ergotamine, or if you have:

• coronary heart disease;
• high blood pressure;
• blood circulation problems;
• sepsis (a severe reaction to an infection);
• liver disease;
• kidney disease; or
• if you are pregnant or could become pregnant.

Many drugs can cause a dangerous decrease in blood flow when used with caffeine and ergotamine. A severe decrease in blood flow to the brain and other parts of the body can lead to dangerous side effects. Some drugs should not be used together with caffeine and ergotamine. Your doctor may change your treatment plan if you also use:

• zileuton;
• an antidepressant--fluoxetine, fluvoxamine, nefazodone;
• an antibiotic--clarithromycin, erythromycin, metronidazole, telithromycin;
• antifungal medicine--clotrimazole, fluconazole, itraconazole, ketoconazole; or
• antiviral medicine to treat HIV/AIDS--indinavir, nelfinavir, ritonavir, saquinavir.

Do not use caffeine and ergotamine if you are pregnant. It could harm the unborn baby or cause birth defects. Use effective birth control to prevent pregnancy while you are using this medicine and tell your doctor if you become pregnant.

You should not breastfeed while using this medicine.

Use Migergot (Rectal) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using caffeine and ergotamine and call your doctor at once if you have:

• severe pain in your stomach or back;
• bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• cramps in your hips or legs, leg pain or swelling;
• weak pulses in your arms and legs, numbness and tingling or pain in your hands or feet, blue-colored fingers or toes;
• muscle pain or weakness in your arms or legs;
• fast or slow heart rate;
• severe headache, blurred vision, pounding in your neck or ears;
• sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance; or
• painful sores on your rectum after using the rectal suppositories.

Serious side effects are more likely with overuse of caffeine and ergotamine. This medicine is not for daily use.

Common side effects may include:

• numbness, tingling, burning pain;
• dizziness, spinning sensation;
• weakness;
• itching or swelling;
• nausea, vomiting; or
• (with suppository use) a rectal sore or ulcer.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Do not use caffeine and ergotamine within 24 hours before or after using another migraine headache medicine, including:

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Grapefruit and grapefruit juice may interact with caffeine and ergotamine and lead to unwanted side effects. Avoid the use of grapefruit products while taking caffeine and ergotamine.