Migergot (Caffeine/Ergotamine) for Migraine

Migergot (caffeine/ergotamine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat or prevent migraine in adults.

How Migergot Works and How It’s Taken

Migergot is an ergot medicine used for migraine headaches. It works by tightening blood vessels in the head, which could lead to decreased migraine pain. Ergotamine also has effects on serotonin, a chemical in the brain that is thought to play a role in migraine.

These actions may help relieve migraine symptoms. Doctors prescribe Migergot when an adult needs treatment at the start of a migraine attack, or in some cases as a short-term preventive treatment.

Migergot is given as a rectal suppository (inserted in the rectum), typically at the first sign of an attack. In some cases, a doctor may recommend short-term use at bedtime to help prevent attacks.

Typical Dosing for Migraine

The recommended dose of Migergot for migraine is one suppository at the start of an attack, followed by a second suppository after one hour if needed for full relief.

Do not use more than two suppositories for a single attack, and do not use more than five suppositories in any seven-day period.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Migergot Side Effects

Migergot can cause serious side effects that may require immediate medical attention.

Serious Side Effects and Warnings

Serious blood vessel narrowing with certain medicines — Serious and life-threatening poor blood flow can occur when Migergot is taken with strong CYP3A4 inhibitors, including protease inhibitors and macrolide antibiotics.
Serious blood vessel narrowing (vasoconstriction) and poor blood flow (ischemia) — These can cause cold, pale, or painful fingers or toes, a weak or absent pulse, or tissue damage, including gangrene.
Heart problems — These can include chest pain, changes on an electrocardiogram, fast or slow heart rate, or high blood pressure.
Cerebral ischemia — Reduced blood flow to the brain can occur.
Ergotism — This serious reaction from ergotamine can cause severe blood vessel narrowing, muscle pain, numbness, coldness, and paleness of the fingers or toes, and it can progress to gangrene.
Fibrotic complications — Rare scarring in areas such as behind the abdomen, the lungs, or heart valves has been reported with long-term continuous use.
Rectal or anal ulcer — A sore in the rectum or anus has been reported with overuse of suppositories.
Allergic reactions — Swelling or itching can occur.

Get medical help right away if you think you are having a serious reaction or allergic reaction.

How To Save on Migergot

Migergot is available as a brand-name medication. Talk to your doctor, pharmacist, or insurance provider if you have questions about coverage or out-of-pocket costs.

What To Know Before Taking Migergot

Tell your doctor if you have any allergies to caffeine/ergotamine or any ingredients in Migergot. Do not take Migergot if you are allergic to any of its ingredients.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements.

Do not take Migergot if you have blood vessel disease, coronary heart disease, high blood pressure, liver or kidney problems, or sepsis. Also do not take Migergot if you use certain medicines called strong CYP3A4 inhibitors, including ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin, troleandomycin, ketoconazole, or itraconazole.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Migergot, talk with your doctor about the risks and benefits. Do not take Migergot if you are pregnant. Migergot may harm your baby if you are pregnant.

Migergot can also pass into breast milk and may cause serious side effects in a nursing baby.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Migergot?

Migergot is used to stop or help prevent migraine and other vascular headaches. Migergot works best when used at the first sign of a migraine attack, and early use gives the best chance for effectiveness. Migergot is not used as a pain reliever for other types of headaches.

How often is Migergot taken for migraine?

For migraine treatment, use one Migergot suppository at the start of an attack. If needed, a second suppository may be used after one hour for full relief. Do not use more than two suppositories for one migraine attack or more than five suppositories in seven days.

Migergot should not be used every day for a long time.

How long does Migergot take to work for migraine?

It is not known how quickly Migergot works for migraine relief. Using Migergot early in a migraine attack gives the best chance for effectiveness.

Should I take Migergot for migraine if I have an infection?

Migergot should not be used in people with sepsis, which is a serious infection. It also should not be used with certain antibiotics, including erythromycin, clarithromycin, and troleandomycin.

These medicines can raise ergotamine levels in the body and increase the risk of serious blood vessel problems.