Methysergide

Brand names of methysergide

  • Sansert

Belonging to the class of drugs called ergot alkaloids, methysergide is indicated for preventing migraine headaches as well as certain types of throbbing headaches. However, this medication is not given to patients once a migraine headache has already triggered off. In addition, this medication is also given to treat cluster headaches - headaches that occur in close sequence at specific times of the year. Such headaches may continue for as many as six to 12 weeks at a stretch.

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It is yet to be ascertained what actually the reason for migraines is. However, it is known that the blood vessels in certain areas of the brain restrict (go into spasm) and subsequently widen (open up) prior to slowly returning to the normal condition. This medication facilitates in preventing migraine headaches by restricting the blood vessels when they open up or dilate.

Things you need to tell your physician before taking methysergide

Whenever you start treatment with a new medication, it is important to exercise a few precautions and same is the case with the prescription drug methysergide. Prior to taking this prescription drug you should tell your physician or pharmacist if you have any allergic reaction to methysergide, to any other ergot alkaloids, such as, methylergonovine or if you have any other allergy problem. Methysergide may enclose a number of inactive elements that may result in allergic reactions or cause other health problems. Hence, you should be aware of all the ingredients of this medication. In case you have any problem, ask your pharmacist to provide you with a list of the ingredients contained in methysergide.

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Methysergide should not be taken by individuals who may be enduring certain medical problems. Thus, before starting treatment with this medication, talk to your physician regarding all your medical conditions, especially if you have any blood vessel disease, for instance peripheral vascular disease, hardening or inflammation of arteries, stroke, Raynaud's disease and/ or blood clots, autoimmune disease, such as rheumatoid arthritis, uncontrolled hypertension (high blood pressure), scarring as a result of taking a drug, such as retroperitoneal fibrosis, heart ailments, for example, heart attack, coronary artery disease, problems of heart valve, acute infection, such as, cellulitis of the feet / legs, sepsis, specific pulmonary ailments, such as pulmonary fibrosis; acute liver ailments, severe kidney disease, deficiency of nourishments, specific types of migraine, for example basilar or hemiplegic migraine and/ or urinary blockage. Before you start taking methysergide, it also important to inform your physician or pharmacist regarding your entire medical history, particularly if you smoke, have diabetes, suffer from uncontrolled high blood pressure (hypertension), and/ or endure stomach/ intestinal ulcers.

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Patients taking methysergide ought to remember that this medication causes dizziness and drowsiness and, hence, they should not undertake tasks that require alertness, such as driving or operating any machinery, unless they are sure about the influence of the medicine on them as well as when they are confident that they are able to fulfill these tasks safely. People taking this prescription drug should restrict consuming alcoholic beverages and quit smoking tobacco. In addition, methysergide should not be given to children as it has the potential to result in scarring or fibrosis among them.

Methysergide has the potential to harm the fetus. Hence, women should not use this medication during pregnancy. In fact, women of marriageable age should use two different effective forms of birth control, such as condoms and oral contraceptives (birth control pills) while they are being treating with this medication. In case any woman becomes pregnant while taking methysergide, she should contact her physician immediately and discuss about her subsequent actions. In addition, she should seek the physician's advice regarding dependable forms of birth control measures. Methysergide is known to pass on to the breast milk resulting in considerable harm to the nursing infants. Therefore, new mothers should not breast feed while taking this medication. It is also advisable that they talk to their physician before breast feeding.

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Usage

Methysergide is an oral prescription medication that is used to avoid vascular headaches, especially those headaches that take place as a result of the changes in normal blood flow inside the blood vessels in the brain. Vascular headaches that can be thwarted by taking methysergide include migraines as well as cluster headaches - headaches occurring in close succession over a prolonged period. As the use of methysergide often results in severe and permanent side effects, this medication is generally prescribed for patient enduring recurrent or disabling headaches when all other medications fail to yield the desired results. In fact, methysergide is a last resort for such patients. It may be noted that this prescription drug is not effective against vascular headaches that have already started and/ or headaches caused by tension.

How to use methysergide

During the initial days of treatment with methysergide, take the medication at night with food or milk with a view to avoid stomach upsets. However, as your physician increases the dose of the medication, you are generally expected to take it two to three times every day along with meals. The dosage of methysergide largely depends on the patient's medical condition as well as his/ her response to the therapy. Generally, your physician will start your treatment with a low dose of the medication and gradually increase the dose with a view to reduce the risks of side effects caused by this medication, especially nausea. After a period of taking methysergide, your physician will adjust the dosage and be able to determine the precise dosage of the medication for you and it is important to strictly follow your physician's instructions while taking this medication.

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The standard highest dose of methysergide for adults is 12 mg every day. In order to obtain the utmost benefit of taking methysergide, you should take this medication on a regular basis and in order to help you remember when to take the medication at the same time daily. If you are taking methysergide for cluster headaches (headaches occurring in quick succession and often lasting for several weeks together), it should be generally taken only when you experience such headaches and stop soon after the headache is gone. It is very important to follow the instructions of your physician very closely while taking this prescription drug. Patients taking methysergide for a prolonged period of time at a stretch are likely to experience very severe side effects. Hence, it is advisable that you should not take this medication for more than six months continuously.

Prior to starting treatment with methysergide, it is important to carefully go through the warning section in the 'Patient User Guide' leaflet available with your pharmacist. Always bear in mind that this medication is not effective in curing vascular headaches, but only helps to prevent their occurrence. Moreover, never use this medication when a vascular headache, such as migraine headache, has already started. In addition, do not stop taking this drug abruptly, for doing so may make your headaches worse and there are chances that they will recur. When you have stopped taking this medication after using it for some time, it is advisable not to start taking it again within three to four weeks. Consult your physician for further details in this regard. Generally, methysergide begins to work after one to two days of taking the medication. People taking this medication should contact their physician if their condition does not improve or worsens even after taking methysergide for around three weeks.

In case you happen to miss a dose of methysergide, take it at the earliest when you remember. However, if it is nearly time for the subsequent normal dose, skip the missed dose and continue with your usual dosing schedule. It is important not to take a double dose of this prescription drug with a view to catch up the missed dose, as it may worsen the side effects.

How methysergide works

While the precise method by which the prescription drug methysergide works is yet to be ascertained, it seems that the action of this medication helps to alleviate vascular headaches by narrowing the blood vessels in the brain. In addition, it is also understood that methysergide obstructs the impact of serotonin - a neurotransmitter (chemical messengers produced and released by the nerves in the brain to communicate with one another), which is known to be related to vascular headaches.

Side effects

Serious
  • abdominal pain
  • chest pain
  • decrease or increase in urine output
  • difficult or painful urination
  • dizziness
  • fever or chills
  • hallucinations
  • itching
  • numbness or tingling
  • pain in the legs, arms, back or side
  • pale or cold feet or hands
  • shortness of breath
  • swelling of hands, feet or lower legs
  • tightness
  • weakness in the legs
Common
  • diarrhea
  • dizziness or light-headedness
  • drowsiness
  • nausea, vomiting
Less common

Possible interactions

As is the case with most drugs, even methysergide may interact with certain other medications, including herbal products, vitamins and minerals and, hence, it is advisable not to take them in conjunction. For instance, as both methysergide as well as St. John's wort may both act on serotonin, it is not advisable to take a combination of these two medications. On the other hand, if you are taking methysergide and also use herbs like ma huang or compounds like ephedrine, it may lead to additive and adverse vasoconstriction (constriction of the blood vessels owing to the action of the nerves).

In case you have allergic reactions to the plants belonging to the Asteraceae family (including chrysanthemum, aster, ragweed and/ or daisy), you are also likely to be allergic to chamomile, Echinacea, St. John's wort and feverfew. In effect, taking methysergide in combination with St. John's wort may result in alterations in the enzymes in the liver that facilitate getting rid of this medication from the body. Hence, it is advisable that you consult your physician prior to adding any herbal product or mineral in your list of medications while you are taking methysergide.

Patients taking methysergide do not have any dietary restrictions, barring the foods that cause allergic reactions among them. It may be noted that a number of vascular headaches are caused by food allergies or have specific foods that trigger such headaches. In effect, maintaining a headache diary may help the patients to identify the foods that stimulate vascular headaches and subsequently keep away from them.

Individuals who are susceptible to vascular headaches ought to keep away from cold environments as exposure to cold is likely to augment the frequency of lessened blood flow (circulation) to the extremities.

Discontinuation

Patients taking methysergide should not stop using this medication all of a sudden, especially if they have been taking the medication for a prolonged period. It is always advisable to consult your physician and seek his approval before you stop taking methysergide permanently. It is best to lower the dose of the medication gradually over two to three weeks before you actually discontinue this medication. Lowering the dose of the medication before stopping its use will help to thwart the recurrence of vascular headaches.

Storage instructions

Methysergide, the prescription drug for preventing vascular headaches, should always be stored at room temperature and in a dark and arid place. You should never store this medication in your bathroom, which is generally damp most of the time. In addition, remember to keep all medications in such a place which is beyond the reach of children and pets.

Unless you have been directed otherwise, never discard the medicines that have passed their expiry date or those that are needed no longer by flushing them down the toilet or pouring them into a drain. All such medications should essentially be disposed of in an appropriate and safe manner. If necessary, you may talk to your neighbourhood waste disposal company or your pharmacist for further details regarding the safe disposal of such medications.

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