Migranal Nasal Spray (Dihydroergotamine Mesylate)

Migranal Nasal Spray (Dihydroergotamine) Medication Information

Uses

Migranal is a nasal spray that is used to treat migraine headaches with or without aura.

Dosage

The nasal spray contains 4 mg of Migranal in a 3.5 mL vial.

Side Effects

The most common side effects of Migranal include:

• Sinusitis
• Nausea
• Vomiting
• Dizziness
• Somnolence
• Fatigue 

Speak with your doctor for a full list of side effects that apply to you if you are taking Migranal.

Precautions

There is a possibility of blood vessel spasms while taking Migranal, which can present as angina. IF this occurs, patients should be evaluated. 

Interactions

The most common drug interactions with Migranal include:

• Triptans
• Beta blocker
• Nicotine
• SSRIs
• Oral contraceptive

Speak with your doctor for more information and before starting a new medication with Migranal. 

Storage

Store below room temperature (77 ºF). Do not refrigerate or freeze. 

Pharmacist Tips

• Migranal is to be used as a nasal spray, it should not be injected. 
• Migranal has not been studied in patients for longer than a year
• Migranal is dosed as one spray in each nostril, and then a second spray in each nostril 15 minutes later.

Dihydroergotamine FAQs

How much Migranal can you use?

There has been no benefit in using more than 2 mg of Migranal.

How long does it take Migranal to work?

Patients typically see relief within 30 minutes of using Migranal.

How many doses are in Migranal?

Each vial contains enough Migranal for 4 sprays, the initial one spray in each nostril, and enough to administer a second spray in each nostril.

How much does Migranal cost?

The average cost of Migranal is around $1000 for 8 vials of 4 sprays.

How often can you use Migranal?

Do not use more than the amount your doctor prescribes. 

Related Drugs

• Axert
• Amerge
• Imitrex
• Relpax
• Zomig Nasal Spray

Reference:

Migranal {package insert}. Bridgewater, NJ: Valcant Pharmaceuticals North America LLC; 2019.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020148Orig1s025lbl.pdf