Migranal is a prescription medication primarily used to treat acute migraine attacks with or without aura. It belongs to the class of drugs known as ergot derivatives, and its active ingredient is Dihydroergotamine Mesylate. When a migraine strikes, blood vessels in the brain constrict and then dilate, leading to painful throbbing headaches. Migranal works by narrowing these blood vessels, effectively reducing the intensity of the headache and alleviating other associated symptoms.

Migranal acts on serotonin receptors in the brain, specifically targeting 5-HT1D receptors. This action inhibits the release of inflammatory neuropeptides, reducing pain transmission and inflammation associated with migraines. By constricting the blood vessels, Migranal helps restore normal blood flow in the brain, bringing relief to migraine sufferers.

Migranal is suitable for adults over the age of 18 years who experience moderate to severe migraines. It is essential to consult a healthcare professional before using Migranal, especially if you have a history of certain medical conditions, such as heart disease, high blood pressure, liver or kidney problems, or a sensitivity to ergot medications.

What are Migraines?

Migraines are severe headaches characterized by intense throbbing or pulsing pain, usually on one side of the head. These headaches can last for hours or even days, significantly impacting a person’s daily life. Accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound, migraines can be debilitating. Migraines can be classified into two main types: migraine with aura and migraine without aura.

Migraine with aura is a type of migraine is characterized by sensory disturbances known as auras that occur before or during the headache. Auras can manifest as visual disturbances, such as flashes of light or blind spots, and may also affect other senses. Migraine without aura is a type of migraine occurs without any preceding sensory disturbances. The headache is the primary symptom, accompanied by other typical migraine features.

The exact causes of migraines are not fully understood, but researchers believe they are influenced by a combination of genetic and environmental factors. Various triggers can lead to migraine attacks, including:

  • Hormonal changes in women
  • Stress and anxiety
  • Certain foods and additives
  • Environmental factors like bright lights and strong odors
  • Changes in sleep patterns
  • Weather fluctuations

Warnings and Precautions

Migraines can be debilitating, affecting millions of people worldwide. Fortunately, there are medications like Migranal that offer relief from these intense headaches. However, it’s essential to use this medication responsibly and with caution.

  • Consult with a Healthcare Professional: Before starting Migranal or any new medication, it is imperative to consult with your healthcare professional. They can evaluate your medical history, current medications, and identify any potential contraindications or allergies.
  • Dosage Adherence: Always follow the prescribed dosage and dosing schedule strictly. Avoid altering the dosage without your doctor’s guidance, as it may lead to adverse effects or reduced efficacy.
  • Pregnancy and Breastfeeding: If you are pregnant or breastfeeding, discuss the potential risks and benefits of using Migranal with your doctor. The drug’s impact on fetal development and breast milk should be carefully considered.
  • Cardiovascular Conditions: Individuals with a history of cardiovascular issues, such as heart disease or hypertension, should exercise caution when using Migranal. The medication can constrict blood vessels, which may exacerbate certain heart conditions.
  • Liver or Kidney Problems: Patients with impaired liver or kidney function should inform their healthcare provider before starting Migranal. Dose adjustments may be necessary to prevent drug accumulation.
  • Allergies and Sensitivities: If you have known allergies or sensitivities to ergot alkaloids or any of Migranal’s components, avoid using the medication, and seek alternative treatment options.
  • Age Considerations: The safety and efficacy of Migranal in pediatric patients have not been established. It is primarily intended for use in adults.
  • Avoid Driving and Operating Machinery: Migranal can cause dizziness or drowsiness in some individuals. If you experience these side effects, avoid driving or operating heavy machinery until they subside.
  • Serotonin Syndrome: Migranal, when used in combination with certain medications like selective serotonin reuptake inhibitors (SSRIs), can lead to serotonin syndrome. Watch for symptoms like confusion, agitation, rapid heartbeat, and seek medical attention if they occur.
  • Nasal Irritation: Migranal is administered through the nasal route and may cause nasal irritation or discomfort. If this occurs, consult your healthcare provider for potential remedies.
  • Tolerance and Overuse: Prolonged or excessive use of Migranal can lead to medication overuse headaches or diminished effectiveness over time. Follow your doctor’s guidelines for its usage.
  • Ergotism Risk: Migranal belongs to the class of ergot alkaloids, and prolonged use or exceeding recommended doses may increase the risk of ergotism, a condition characterized by vasoconstriction.
  • Elderly Patients: Elderly patients may be more sensitive to the effects of Migranal. Close monitoring is essential to avoid potential complications.
  • Mental Health Conditions: Patients with a history of mental health conditions should use Migranal with caution, as it may exacerbate anxiety or depression.
  • Smoking and Migranal: Smoking while using Migranal can reduce the medication’s effectiveness. If you smoke, discuss it with your healthcare provider.
  • Hemiplegic or Basilar Migraines: Migranal is contraindicated in patients with hemiplegic or basilar migraines due to the risk of stroke.
  • Central Nervous System Sensitivity: Individuals with heightened sensitivity to drugs affecting the central nervous system should use Migranal with caution.
  • Withdrawal Symptoms: Abruptly stopping Migranal can lead to withdrawal symptoms. Taper off the medication as per your healthcare provider’s instructions.
  • Eye and Vision Issues: Migranal may cause eye-related side effects like visual disturbances. Consult your doctor if you experience any vision changes.
  • Patient Education: Educate yourself about the proper use of Migranal, potential side effects, and warning signs of adverse reactions.
  • Emergency Situations: In case of severe allergic reactions or adverse effects, seek immediate medical attention or call emergency services.
  • Combination Medications: Avoid using other migraine medications alongside Migranal without your doctor’s approval. Some combinations may lead to dangerous interactions.

Side Effects

While Migranal can be highly effective in managing migraines, it is essential to be aware of its potential side effects.

Common Side Effects

  1. Nausea and Vomiting: Some individuals may experience mild nausea or vomiting after using Migranal.
  2. Dizziness: A feeling of dizziness or lightheadedness can occur as a common side effect.
  3. Nasal Discomfort: Migranal is administered through the nose, and it can cause nasal discomfort or irritation.
  4. Throat Irritation: Some users may experience mild irritation in the throat after using Migranal.
  5. Fatigue: A temporary feeling of tiredness or fatigue might occur in some cases.
  6. Flushing: Migranal can cause skin flushing, leading to a temporary redness or warmth in the face.
  7. Sensitivity to Light and Sound: Certain individuals may become more sensitive to light and sound while using Migranal.

Rare Side EffectS

  1. Chest Pain: In rare instances, Migranal can cause chest pain or discomfort. If this occurs, medical attention should be sought immediately.
  2. Increased Blood Pressure: Some individuals may experience a temporary increase in blood pressure levels.
  3. Nasal Ulcers: In very few cases, Migranal use may lead to the development of nasal ulcers.
  4. Numbness or Tingling: Rarely, Migranal can cause tingling sensations or numbness in certain body parts.
  5. Abdominal Pain: In isolated cases, users may experience abdominal pain or discomfort.
  6. Confusion: Migranal can, in rare cases, lead to confusion or difficulty with cognitive functions.

Severe Side Effects

  1. Allergic Reaction: Some individuals may experience a severe allergic reaction to Migranal, characterized by hives, difficulty breathing, and swelling of the face, lips, tongue, or throat.
  2. Chest Tightness: Severe chest tightness or pressure may be experienced by some users.
  3. Severe Abdominal Pain: In rare cases, Migranal can cause intense abdominal pain or cramping.
  4. Vision Changes: Migranal may lead to sudden and severe vision changes, including blurred vision or partial vision loss.
  5. Severe Dizziness: Some individuals may experience severe dizziness or fainting spells.
  6. Significant Increase in Blood Pressure: In very rare instances, Migranal can cause a dangerous spike in blood pressure levels.
  7. Stroke: While exceedingly uncommon, there have been extremely rare cases of strokes associated with Migranal use.


Migraines can be debilitating, affecting millions of people worldwide. Migranal, a medication commonly used to treat migraines, can be effective in providing relief. However, like any other medication, Migranal can interact with other drugs, herbs, and foods, potentially leading to adverse effects or reduced efficacy.

Drug Interactions

  1. Protease Inhibitors: The concomitant use of Migranal with protease inhibitors (antiviral drugs) can increase the risk of ergotism, a serious condition that causes blood vessel constriction, leading to severe complications.
  2. Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Combining Migranal with SSRIs or SNRIs may result in serotonin syndrome, a potentially life-threatening condition characterized by agitation, hallucinations, and changes in blood pressure.
  3. Beta-Blockers: Concurrent use of beta-blockers and Migranal may lead to increased blood pressure and decreased efficacy of both medications.
  4. Other Ergot Alkaloids: Combining Migranal with other ergot alkaloids or medications containing ergotamine should be avoided due to the risk of ergotism.
  5. CYP 3A4 Inhibitors: Drugs that inhibit the enzyme CYP 3A4, such as certain antifungals and antibiotics, can increase the concentration of Migranal in the blood, potentially leading to adverse effects.
  6. CYP 3A4 Inducers: Conversely, drugs that induce the enzyme CYP 3A4, like certain anticonvulsants, can reduce Migranal’s effectiveness.

Herbal Interactions

  1. St. John’s Wort: This popular herbal supplement, used to treat depression, can induce CYP 3A4 enzymes, potentially reducing Migranal’s effectiveness.
  2. Ginkgo Biloba: Ginkgo may increase the risk of bleeding when used with Migranal, particularly in individuals with bleeding disorders.
  3. Feverfew: Feverfew, commonly used for migraines, may interact with Migranal and lead to increased blood pressure or reduced efficacy.
  4. Ginseng: Ginseng can alter blood pressure and may interact with Migranal in individuals with hypertension.

Food Interactions

  1. Grapefruit and Grapefruit Juice: Grapefruit contains compounds that inhibit CYP 3A4 enzymes, leading to increased Migranal levels in the blood and a higher risk of adverse effects.
  2. Tyramine-Rich Foods: Tyramine, a compound found in aged cheeses, cured meats, and certain fermented foods, can cause a sudden increase in blood pressure when combined with Migranal.
  3. Caffeine: While some studies suggest caffeine can enhance the effects of Migranal, excessive caffeine intake may lead to vasoconstriction and worsen migraine symptoms.
  4. Alcohol: Alcohol consumption can intensify the side effects of Migranal, such as dizziness and drowsiness.

How to Use

Migranal can be an effective tool in managing and alleviating migraine attacks. By understanding its proper usage, dosing, and potential side effects, you can optimize the benefits of this medication.

  1. Gently blow your nose to clear your nostrils.
  2. Hold the nasal spray upright, with your thumb at the base and your index and middle fingers on the pump.
  3. Tilt your head slightly forward and insert the nozzle into one nostril.
  4. Close the other nostril with your finger.
  5. Begin to breathe in through your nose slowly, while simultaneously pumping the spray.
  6. Breathe gently through your mouth after each spray to ensure the medication reaches your nasal passages.


Proper dosing is essential to achieve optimal relief while minimizing side effects.

Initial Dosage

The initial dosage of Migranal is crucial to gauge its effectiveness and tolerability for an individual. The usual starting dose for migraines is 1 mg, administered intranasally. This can be repeated after one hour if necessary, with a maximum total dose of 3 mg per day.

Maintenance Dosage

After determining the initial dosage’s efficacy, the maintenance dose can be established. For most individuals, the typical maintenance dose ranges from 1 mg to 2 mg, administered intranasally. However, the actual dosage may vary based on the frequency and severity of migraine attacks.

What to Do if a Dose is Missed?

If you miss a scheduled dose of Migranal, take it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for the missed one.

Avoiding Overdose

An overdose of Migranal can lead to serious side effects. It is crucial to stick to the prescribed dosages and not exceed the recommended limits. If you accidentally take more than the prescribed dose, seek immediate medical attention.


Following the correct storage procedures will help to preserve the potency and quality of the medication, ensuring that it remains safe and effective when needed.

  1. Store at Room Temperature: Migranal should be stored at room temperature, typically between 20°C to 25°C (68°F to 77°F). Avoid exposing the medication to extreme temperatures, such as direct sunlight or excessive heat, as it may affect its stability.
  2. Keep Away from Moisture: Moisture can degrade the quality of Migranal. Always store the medication in its original container, and make sure the container is tightly closed after each use to prevent moisture from getting inside.
  3. Keep Out of Reach of Children and Pets: Store Migranal in a secure location, out of the reach of children and pets. Accidental ingestion can lead to serious health risks.
  4. Avoid Freezing: Do not freeze Migranal. Freezing can alter the drug’s composition and render it ineffective.
  5. Protect from Light: Exposure to light can degrade the active ingredients in Migranal. Keep the medication in its original container, which is designed to protect it from light.
  6. Check Expiry Date: Before using Migranal, always check the expiration date on the packaging. Expired medications may not provide the desired therapeutic effects and should be disposed of properly.
  7. Do Not Transfer to Another Container: It’s essential to keep Migranal in its original container to maintain its integrity and avoid confusion with other medications.
  8. Store Away from Heat Sources: Keep Migranal away from direct heat sources, such as radiators or heating vents. High temperatures can accelerate drug degradation.
  9. Don’t Store in the Bathroom: The bathroom can be humid, which is not suitable for storing medications. Instead, choose a cool, dry place for storing Migranal.
  10. Keep in a Dark Place: To protect Migranal from light exposure, store it in a dark place, such as a medicine cabinet or drawer.
  11. Maintain Consistent Temperature: Avoid fluctuations in temperature. For instance, do not store Migranal near a stove or in the refrigerator.
  12. Store in a Child-Resistant Container: If the medication comes in a child-resistant container, ensure that it is properly closed after each use to maintain its safety features.
  13. Avoid Extreme Humidity: High humidity levels can compromise the quality of Migranal. It’s best to store the medication in a location with controlled humidity levels.
  14. Keep Packaging Intact: Ensure that the packaging of Migranal remains intact and undamaged. If the packaging is compromised, consider contacting the pharmacy for a replacement.
  15. Store Away from Electronics: Electronic devices like smartphones, laptops, or tablets generate heat. Avoid storing Migranal near such devices.
  16. Separate from Food and Beverages: To prevent accidental ingestion, store Migranal away from food and beverages.
  17. Do Not Share Medications: Migranal is a prescription medication intended for individual use. Avoid sharing it with others, even if they have similar symptoms.
  18. Avoid Extreme Cold: Migranal should not be exposed to extremely cold temperatures, such as storing it in a freezer.
  19. Properly Discard Unused Medication: If you have any expired or unused Migranal, dispose of it properly according to local regulations or consult with a pharmacist.
  20. Check for Particulate Matter or Discoloration: Before using Migranal, inspect the solution for any signs of particulate matter or discoloration. If present, avoid using the medication and contact your healthcare provider.
  21. Store at the Right Location: Choose a safe, accessible, and consistent location for storing Migranal. This will help you remember to take your medication regularly.
  22. Follow Specific Storage Instructions: If your doctor or pharmacist provides specific storage instructions for Migranal, be sure to follow them diligently.
  23. Keep Medication Information Handy: Store the package insert or medication information leaflet alongside Migranal for easy reference.
  24. Transportation Tips: When traveling with Migranal, carry it in a cool, dark, and secure place, such as a travel pill organizer.
  25. Dispose of Medications Responsibly: If you no longer need Migranal or if it has passed its expiration date, dispose of it responsibly to prevent accidental ingestion or environmental contamination.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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