Treatment of acute migraine attack: Role of nasal spray dihydroergotamine

G. Sandrini

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Dihydroergotamine (DHE) has been used in the treatment of migraine since 1945, both for prophylaxis ant for treatment of acute migraine attack. A new nasal spray formulation has been recently registered in Italy and is now available. Therapeutic efficacy of intranasal DHE has been evaluated in at least nine double-blind, placebo controlled trials. In all studies DHE was significantly more effective than placebo in reducing headache, functional disability, nausea and vomiting, with 27% of patients having a significant reduction of headache pain within the first 30 minutes after DHE administration. Very low (15%) were headache recurrences within the first 24 hours. Nasal DHE is very rapidly absorbed by the nasal mucosa and this particular route of administration allows to avoid first pass metabolism of DHE, with a full clinical efficacy. 2 mg/attack was the optimal effective dosage, obtained administering 1 mg (one 0,5 mg puff for each nostril) at the beginning of the attack, followed by a second 1 mg administration (one 0.5 mg puff for each nostril), after 15 minutes. Local and systemic tolerability of DHE nasal spray was very good, with the most common side effetct beeing a sligth local irrtation. These results confirm that DHE nasal spray is an effective and well tolerated migraine treatment, with a very suitable formulation for headache attack, frequently accompained by nausea and/or vomiting.

Original languageEnglish
Pages (from-to)96
Number of pages1
JournalItalian Journal of Neurological Sciences
Issue number4
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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