Trudhesa (Dihydroergotamine) for Migraine

Overview
Trudhesa is approved by the U.S. Food and Drug Administration (FDA) for the acute treatment of migraine with or without aura in adults. It is not approved for the preventive treatment of migraine or for treating hemiplegic or basilar migraine. Trudhesa should not be used if other migraine medications like 5-HT1 agonists or ergot-type drugs have been taken within the past 24 hours. Trudhesa is also known by its drug name, dihydroergotamine.

Trudhesa belongs to a class of medications called ergot alkaloids. It works by narrowing the widened blood vessels in the brain believed to cause migraine symptoms. This helps relieve pain and other symptoms associated with migraine, such as nausea and sensitivity to light and sound.

How do I take it?
Prescribing information states that Trudhesa is taken as a nasal spray. A single dose consists of one spray into each nostril. If needed, a second dose may be taken at least one hour after the first, but no more than two doses in 24 hours or three doses in a seven-day period should be used.

Before using Trudhesa, a cardiovascular evaluation is recommended. The device must be assembled and primed (sprayed 4 times) before use, and should be used immediately and then discarded. Trudhesa should always be taken exactly as prescribed by a healthcare provider.

Side effects
Common side effects of Trudhesa include rhinitis (nasal inflammation), nausea, altered sense of taste, application site reactions (such as nasal irritation), dizziness, vomiting, somnolence (drowsiness), pharyngitis (sore throat), and diarrhea.

Rare but serious side effects may include peripheral ischemia (reduced blood flow to limbs), myocardial ischemia or infarction (reduced blood flow or heart attack), cerebral hemorrhage or stroke, vasospasm (blood vessel narrowing), elevated blood pressure, fibrotic complications (such as lung or abdominal tissue scarring with prolonged use), preterm labor, and serotonin syndrome (a potentially dangerous reaction when used with certain antidepressants). Trudhesa should not be used with strong CYP3A4 inhibitors, beta blockers, or nicotine, as these can increase the risk of vasoconstriction.

For more information about this treatment, visit:

Trudhesatm (Dihydroergotamine Mesylate) Nasal Spray — Impel Pharmaceuticals