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Ergotamine and Caffeine

Ergotamine and Caffeine is a combination medicine used to stop or prevent vascular headaches, such as migraine, and is available as oral tablets and as a rectal suppository.

Brand names CafergotMigergot Rectal SuppositoryCafatine Rectal SuppositoryCafergot Rectal SuppositoryCafetrate Rectal Suppository +3 more
Drug classes Central Nervous System Stimulant
Rx Forms 2
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026 Content updated Oct 2, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 3 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

How we combine label and product data →
✓No current FDA shortage listed · checked Oct 2, 2026
Ergotamine and Caffeine at a glance The quick version — the full detail is in the Patient Information Guide below.
Dr. Brian Staiger, PharmD, BCPS
The Pharmacist’s Take By · Clinical pharmacist · Written
Ergotamine and Caffeine can stop or prevent migraine and related vascular headaches when taken early. It carries serious circulation risks, especially with certain antibiotics, antifungals and HIV medicines. Always check your full medicine list with a pharmacist or prescriber before using it.
How we write & review this content — our editorial policy →
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾

Do not take this medicine with strong CYP 3A4 inhibitors, including HIV protease inhibitors and macrolide antibiotics. These drugs raise ergotamine levels in your blood. That can cause severe spasm of blood vessels, leading to reduced blood flow to the brain or to your arms and legs.

Watch for cold, numb, pale or bluish fingers or toes. Also watch for severe headache or other new brain-related symptoms. Seek urgent medical care if these occur.

Read the full warning on DailyMed →
How you get itPrescription only
Comes asTablet, Rectal suppository
Earliest FDA record1983
Companies listing it with the FDA5
FDA label last updatedMar 27, 2025
FDA’s strongest warning (boxed)Yes, read the warning

Patient information guide — a plain-language walkthrough of Ergotamine and Caffeine, written from its FDA label.

What Ergotamine and Caffeine is used for

▾

Ergotamine and Caffeine is used for vascular headaches.

  • Migraine, to stop an attack or prevent one
  • Migraine variants
  • So-called “histaminic cephalalgia”
  • Cafergot and ergotamine tartrate and caffeine tablets are taken orally for these uses.
  • Migergot is a rectal suppository for the same uses.

How Ergotamine and Caffeine works

▾

Ergotamine blocks certain adrenaline-type (alpha adrenergic) signals and serotonin. It also directly tightens the smooth muscle of blood vessels in the head and body. Caffeine also narrows blood vessels in the head and boosts the effect without raising the ergotamine amount.

Many people with migraine have heavy nausea and vomiting and cannot keep oral medicine down. The rectal route lets the medicine reach the blood vessels of the head directly, bypassing the gut blood supply and the liver.

Ergotamine and Caffeine dosage

▾

It works best when taken at the first sign of an attack. Follow your prescriber and the label, since each product has its own limits.

  • Cafergot and ergotamine tartrate and caffeine tablets are taken by mouth, with more tablets spaced about half an hour apart if needed. There are limits per attack and per week.
  • Migergot is used rectally. A second suppository may be used after 1 hour if needed. It also has limits per attack and per week.
  • None should be used for chronic daily treatment.
  • In carefully selected patients, a bedtime dose may be a short-term preventive measure.

Dosing details from the FDA-approved label

From the Ergotamine and Caffeine prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.

  • Adults – Migergot (ergotamine tartrate and caffeine) rectal suppository, migraine attack
    • One suppository at start of attack
    • Second suppository after 1 hour, if needed for full relief
    • Dosage should start at the first sign of an attack
    • Early administration gives maximum effectiveness
    • Maximum: Two suppositories is the maximum dose for an individual attack. Total weekly dosage should not exceed 5 suppositories.
    • Not for chronic daily administration; in carefully selected patients, administration at bedtime may be an appropriate short-term preventive measure.
  • Adults – Cafergot (ergotamine tartrate and caffeine) oral tablets, migraine attack
    • Take 2 tablets at the start of attack
    • 1 additional tablet every ½ hour, if needed for full relief
    • Dosage should start at the first sign of an attack
    • Maximum: Maximum 6 tablets per attack, 10 per week. Total daily dose for any one attack should not exceed 6 tablets; total weekly dosage should not exceed 10 tablets.
    • Not for chronic daily administration; in carefully selected patients, administration at bedtime may be an appropriate short-term preventive measure.
Read the label’s full dosing text

DOSAGE AND ADMINISTRATION Procedure For best results, dosage should start at the first sign of an attack. Rectally Two suppositories is the maximum dose for an individual attack. Total weekly dosage should not exceed 5 suppositories. Ergotamine Tartrate and Caffeine Suppositories should not be used for chronic daily administration. In carefully selected patients, with due consideration of maximum dosage recommendations, administration of the drug at bedtime may be an appropriate short-term preventive measure. Maximum Adult Dosage: One suppository at start of attack; second suppository after 1 hour, if needed for full relief. Early administration gives maximum effectiveness.

Read the full Dosage and Administration section on DailyMed →

Ergotamine and Caffeine side effects

▾

Common side effects

  • Nausea and vomiting
  • Tingling or “pins and needles” (paresthesias)
  • Numbness
  • Weakness
  • Vertigo (spinning dizziness)
  • Localized swelling and itching
  • Temporary fast or slow heartbeat
  • Muscle pains

When to get medical help

  • Cold, numb, pale or bluish fingers or toes, or loss of a pulse in a limb. These can signal blocked blood flow.
  • Chest pain or tightness
  • Muscle pain with signs of poor circulation in the arms or legs
  • Rectal or anal ulcer or pain from overusing suppositories
  • Shortness of breath or chest problems with long-term use, which can signal fibrosis (scar-like tissue)
  • Signs of overdose such as drowsiness, convulsions, or severe vomiting

Common effects include:

  • Nausea and vomiting
  • Tingling, numbness, weakness and vertigo
  • Localized swelling and itching
  • Temporary fast or slow heartbeat, and high blood pressure
  • Muscle pains
  • Rectal or anal ulcer from overusing suppositories

Get urgent help for cold, blue or numb limbs, absent pulse, or chest pain. These can signal serious circulation problems.

Ergotamine and Caffeine warnings and precautions

▾
  • Dangerous drug interactions: Strong CYP 3A4 inhibitors can cause severe blood vessel spasm, with cases leading to amputation or death.
  • Circulation problems: These can occur even at normal doses.
  • Fibrosis: Long-term continuous use has been linked to scarring in the abdomen and lungs and to heart valve thickening.
  • Pregnancy: It may cause fetal harm.
  • Overuse: Do not use it daily.

Ergotamine and Caffeine interactions

▾

Many drugs can raise ergotamine levels or add to its effects.

  • Ritonavir, nelfinavir, indinavir: contraindicated, since they raise ergotamine levels.
  • Erythromycin, clarithromycin, troleandomycin: contraindicated for the same reason.
  • Ketoconazole, itraconazole: contraindicated, as potent CYP 3A4 inhibitors.
  • Saquinavir, nefazodone, fluconazole, fluoxetine, fluvoxamine, zileuton, metronidazole, clotrimazole, grapefruit juice: weaker inhibitors that still carry a potential risk.
  • Other vasoconstrictors: added blood vessel narrowing.
  • Sympathomimetics (pressor agents): may sharply raise blood pressure.
  • Propranolol (Inderal): may increase ergotamine’s blood-vessel-narrowing effect.
  • Nicotine: may narrow blood vessels and raise ischemia risk.

Interactions listed in the FDA-approved label

From the Ergotamine and Caffeine prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.

  • CYP 3A4 inhibitors (e.g. macrolide antibiotics and protease inhibitors): Blood levels of ergotamine-containing drugs are reported to be elevated by concomitant macrolide antibiotics, and vasospastic reactions have been reported with therapeutic doses when coadministered with these antibiotics. See CONTRAINDICATIONS and WARNINGS.
  • Other vasoconstrictors: Ergotamine tartrate and caffeine tablets should not be administered with other vasoconstrictors. Should not be administered together.
  • Sympathomimetics (pressor agents): Use with sympathomimetics may cause extreme elevation of blood pressure.
  • Beta-blocker Inderal (propranolol): Propranolol has been reported to potentiate the vasoconstrictive action of ergotamine tartrate and caffeine tablets by blocking the vasodilating property of epinephrine.
  • Nicotine: Nicotine may provoke vasoconstriction in some patients, predisposing to a greater ischemic response to ergot therapy.
Read the label’s full interactions text

Drug Interactions - CYP 3A4 Inhibitors (e.g. Macrolide Antibiotics and Protease Inhibitors) See CONTRAINDICATIONS and WARNINGS . Ergotamine tartrate and caffeine tablets should not be administered with other vasoconstrictors. Use with sympathomimetics (pressor agents) may cause extreme elevation of blood pressure. The beta-blocker Inderal (propranolol) has been reported to potentiate the vasoconstrictive action of ergotamine tartrate and caffeine tablets by blocking the vasodilating property of epinephrine. Nicotine may provoke vasoconstriction in some patients, predisposing to a greater ischemic response to ergot therapy. The blood levels of ergotamine-containing drugs are reported to be elevated by the concomitant administration of macrolide antibiotics and vasospastic reactions have been reported with therapeutic doses of the ergotamine-containing drugs when coadministered with these antibiotics.

Read the full Drug Interactions section on DailyMed →

Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.

🌿208 supplements and herbs with documented Ergotamine and Caffeine interactions, ranked by severity Check Ergotamine and Caffeine against a supplement or herb →

Before taking Ergotamine and Caffeine

▾
  • Pregnant or possibly pregnant women should not use it.
  • Peripheral vascular disease
  • Coronary heart disease
  • High blood pressure
  • Impaired liver or kidney function
  • Sepsis
  • Allergy to any component
  • Use of any strong CYP 3A4 inhibitor

Ergotamine and Caffeine overdose

▾

Overdose effects come mainly from ergotamine. They include vomiting, numbness, tingling, pain and bluish discoloration of the limbs, weak or absent pulses, and changes in blood pressure. Drowsiness, stupor, coma, convulsions and shock can also occur.

Treatment involves removing the drug from the body and supporting breathing and blood pressure. Warmth, but not heat, and protection of affected limbs help with vessel spasm. Get emergency help right away.

What Ergotamine and Caffeine does in the body

▾

Ergotamine narrows peripheral and cranial blood vessels and dampens central vasomotor centers. It also has serotonin-blocking properties. Compared with hydrogenated ergotamine, its adrenergic blocking is weaker and its vessel-narrowing is stronger. Caffeine adds to the narrowing of blood vessels in the head.

How your body processes Ergotamine and Caffeine

▾

Ergotamine is broken down by the liver enzyme CYP 3A (cytochrome P450 3A). Drugs that block this enzyme, such as certain macrolide antibiotics and protease inhibitors, raise ergotamine blood levels. Ergotamine itself can also inhibit CYP 3A reactions. No interactions with other cytochrome P450 enzymes are known.

How to store Ergotamine and Caffeine

▾

Store and Dispense The suppositories should be refrigerated at 2° to 8°C (36° to 46°F).

Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →

208

Supplements & herbs that interact with Ergotamine and Caffeine

208 supplements and herbal products have documented interactions with Ergotamine and Caffeine in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 7
  • Moderate · 155
  • Minor · 46
ACTIVATED CHARCOAL Major EPHEDRA Major GRAPEFRUIT Major PEYOTE Major RAUVOLFIA VOMITORIA Major SIDA CORDIFOLIA Major ST. JOHN'S WORT Major 1,3-DMAA Moderate +200 more
Every supplement checked against Ergotamine and Caffeine — ranked by severity The full interaction hub: 7 major · 155 moderate · 46 minor · every one linked to its full report. Check Ergotamine and Caffeine against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

1

Nutrient depletion considerations

Ergotamine and Caffeine has been associated with lower levels of 1 nutrient in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.

POTASSIUM Moderate Depletion
See the full Ergotamine and Caffeine nutrient depletion report

Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.

Ergotamine and Caffeine: pharmacist answers to common questions

Quick, plain-English answers to the questions patients ask most about Ergotamine and Caffeine — the kind of thing our pharmacy team would talk through with you at the counter.

What is this medicine for?

▾
It is used to stop or prevent vascular headaches like migraine. It works best when you take it at the very first sign of an attack. It is not meant for everyday use.

Can I take it every day to prevent migraines?

▾
No. It should not be used for chronic daily treatment. Long-term continuous use has been linked to scarring in the abdomen, lungs and heart valves. Stick to the per-attack and weekly limits on your label.

What if I'm taking antibiotics or HIV medicine?

▾
Tell me before you leave the counter. Certain antibiotics like erythromycin and clarithromycin, HIV protease inhibitors, and antifungals like ketoconazole and itraconazole must not be combined with this. The mix can seriously cut blood flow to your brain or limbs.

What side effects are normal, and which are not?

▾
Nausea, vomiting, tingling, numbness, weakness and dizziness can happen. Cold, pale or blue fingers or toes, chest pain, or a missing pulse are not normal. Get medical help right away if you notice those.

Is it safe in pregnancy?

▾
No. It may harm an unborn baby and should not be used if you are pregnant or could become pregnant. Talk to your prescriber about other options.

I get bad nausea with migraines. Should I take the tablets?

▾
The label notes that severe nausea and vomiting can make it hard to keep oral medicine down. In that case the rectal suppository, Migergot, is a different route that your prescriber may consider. Follow the directions for whichever product you are given.

Is Ergotamine and Caffeine available over the counter?

▾
Ergotamine and Caffeine is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.

When was Ergotamine and Caffeine first available?

▾
Ergotamine and Caffeine has been available in the United States since at least 1983, based on FDA approval history (Drugs@FDA) and product marketing records.

Who makes Ergotamine and Caffeine?

▾
Ergotamine and Caffeine is supplied by 5 manufacturers listed in the FDA NDC Directory, including Cosette Pharmaceuticals, Inc., Cintex Services, LLC, Sandoz Inc.

Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →

More about Ergotamine and Caffeine on HelloPharmacist

📊Ergotamine and Caffeine supplement interactions208 checked — ranked by severity 🌿Drug & Supplement CheckerErgotamine and Caffeine vs. vitamins & herbs 💬Ask a PharmacistFree answer, usually < 24h 🔎NDC & pricing lookupFind Ergotamine and Caffeine NDCs & costs 🅰️Browse Drugs A–ZLook up any medication
Detailed data & references for Ergotamine and Caffeine Forms & strengths, pricing, billing codes, manufacturers, safety reports and sourcing — the data behind the page. Most people can stop here. Each section below opens on a tap.

Ergotamine and Caffeine forms and strengths (how it comes)

Ergotamine and Caffeine is available in 2 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Tablet

By mouth
Brands Cafergot
How this form is used
What it may be used for
  • Cafergot and ergotamine tartrate and caffeine tablets are used to abort or prevent vascular headache, such as migraine, migraine variants or “histaminic cephalalgia.”
Important instructions
  • Cafergot and ergotamine tartrate and caffeine tablets should be started at the first sign of an attack.
  • These tablets are taken by mouth, with further tablets spaced out if needed for full relief.
  • These tablets have daily and weekly limits, so follow the label and your prescriber.
  • These tablets should not be used for chronic daily administration.
Available strengths 2 strengths
1 mg / 100 mg 100 mg / 1 mg
5 FDA-listed product records ⓘ

Rectal suppository

Rectal
Brands Migergot
How this form is used
What it may be used for
  • Migergot is used to abort or prevent vascular headache, such as migraine, migraine variants or “histaminic cephalalgia.”
Important instructions
  • Migergot should be started at the first sign of an attack.
  • Migergot is used rectally, with a second suppository after 1 hour only if needed for full relief.
  • Migergot has limits per attack and per week, so follow the label and your prescriber.
  • Migergot should not be used for chronic daily administration.
Available strengths 2 strengths
2 mg / 100 mg 100 mg / 2 mg
2 FDA-listed product records ⓘ

Ergotamine and Caffeine on the U.S. market: products, makers and brands

How Ergotamine and Caffeine appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

5 companies list 7 Ergotamine and Caffeine product records with the FDA, mostly as tablet, rectal suppository; the earliest marketing or approval year on record is 1983. Brand names on the directory include Cafergot, Migergot Rectal Suppository, Cafatine Rectal Suppository and 5 more; the rest are generics.

2
Dose forms ⓘ
5
Labelers (makers, repackagers, distributors)
4
Brand names
7
FDA-listed product records ⓘ
1983
Earliest FDA record ⓘ

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Cosette Pharmaceuticals, Inc.29%
Cintex Services, LLC29%
Sandoz Inc14%
KMM Pharmaceuticals, LLC14%
Trifluent Pharma, LLC14%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Compare Ergotamine and Caffeine products

A representative set of FDA-listed product records for Ergotamine and Caffeine — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Strength Route Manufacturer / Labeler Category ⓘ Details
💊Rectal suppository
ERGOTAMINE TARTRATE 2 mg/1; CAFFEINE 100 mg Rectal Cosette Pharmaceuticals, Inc. ANDA View NDC →
100; 2 mg/1; mg Rectal Cosette Pharmaceuticals, Inc. ANDA View NDC →
💊Tablet
ERGOTAMINE TARTRATE 1 mg/1; CAFFEINE 100 mg Oral Cintex Services, LLC ANDA View NDC →
100; 1 mg/1; mg Oral Cintex Services, LLC ANDA View NDC →
100; 1 mg/1; mg Oral KMM Pharmaceuticals, LLC ANDA View NDC →
100; 1 mg/1; mg Oral Sandoz Inc ANDA View NDC →
ERGOTAMINE TARTRATE 1 mg/1; CAFFEINE 100 mg Oral Trifluent Pharma, LLC ANDA View NDC →

Showing 7 of 7 products — FDA National Drug Code Directory. See every product, package size and price: browse all 7 Ergotamine and Caffeine NDCs →

Ergotamine and Caffeine recall history

A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.

The FDA’s enforcement reports list no Ergotamine and Caffeine recalls since July 2021.

✅No Ergotamine and Caffeine recalls on record since July 2021

Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one exact multiple-ingredient concept (MIN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). A product with a different ingredient combination belongs on a different page.

Multiple ingredients (MIN) Ergotamine and Caffeine RxCUI 214336 2 dose forms · 2 strengths

Look up RxCUI 214336 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

Ergotamine and Caffeine brand names

Ergotamine and Caffeine is sold under 8 brand names in the FDA directory — Cafergot, Migergot Rectal Suppository, Cafatine Rectal Suppository, Cafergot Rectal Suppository and others. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.

Cafergot Migergot Rectal Suppository Cafatine Rectal Suppository Cafergot Rectal Suppository Cafetrate Rectal Suppository Ercaf Wigraine Migergot

Who makes Ergotamine and Caffeine: manufacturers and labelers

5 companies list Ergotamine and Caffeine products with the FDA. By number of product records, the largest are Cosette Pharmaceuticals, Inc., Cintex Services, LLC, Sandoz Inc. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.

Cosette Pharmaceuticals, Inc. 2 Cintex Services, LLC 2 Sandoz Inc 1 KMM Pharmaceuticals, LLC 1 Trifluent Pharma, LLC 1

Ergotamine and Caffeine drug class (RxNorm)

Ergotamine and Caffeine belongs to the Central Nervous System Stimulant class.

Pharmacologic class Central Nervous System Stimulant, Methylxanthine
Drug family (ATC) Tests for gastric secretion, Other dermatologicals, Xanthine derivatives

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

Sources for this Ergotamine and Caffeine page

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Mar 27, 2025
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Ergotamine and Caffeine.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Ergotamine and Caffeine after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
3
NDC products indexed
7
Distinct labelers/manufacturers represented
5
Linked representative label ⓘ
Cintex Services, LLC
Linked label effective
Mar 27, 2025
Composite sections available
18
Linked SPL Set ID
41f88ae7-c124-5b9c-e054-00144ff88e88
Linked SPL Document ID
31576cda-7134-cc0b-e063-6294a90acef8
Open the linked representative label on DailyMed ↗

How this page is built

HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Cintex Services, LLC is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →