Migranal

The recommended dose of dihydroergotamine is one spray in each nostril (total of 2 sprays) at the first sign or symptom of a migraine headache, or as early as possible after the onset of migraine headache pain. If the migraine has not improved sufficiently after about 15 minutes, one additional spray can be used in each nostril (total of 2 more sprays).

One bottle of dihydroergotamine nasal spray contains 4 sprays. No more than 4 sprays (2 in each nostril, i.e., one bottle) should be used for any migraine attack. No more than 8 sprays (2 bottles) should be used in any 24-hour period. No more then 24 sprays (6 bottles) should be used in any 7-day period.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use Migranal (Dihydroergotamine-nasal) exactly as prescribed by your doctor.

The spray should be used in the following manner (see package insert for illustrated details):

• Start to prepare the sprayer only when you have a migraine attack.
• Slowly lift and bend back the lip of the blue seal to show the rubber stopper. Try not to break the blue seal.
• Completely remove the seal and metal collar in one piece, if possible. If the two should break apart, carefully continue removing the metal collar. The collar has a sharp edge - handle it with care.
• Gently pull the rubber stopper out of the bottle. Be careful not to spill the contents.
• Gently remove the transparent plastic protective cover from the bottom of the sprayer. Insert the sprayer into the bottle and tighten firmly onto the bottle in a clockwise direction.
• Holding the bottle upright, gently remove the blue plastic protective cap from the top of the sprayer.
• Prior to use, the sprayer must be primed (pumped 4 times in the air).
• Hold your head straight.
• Insert the sprayer into one nostril and pump the sprayer once to release the medication. Repeat in the other nostril (a total of 2 sprays).
• Don't blow your nose.
• Wait about 15 minutes. If you have not already experienced sufficient relief, or to obtain optimal efficacy and long-lasting relief, repeat the spray once in each nostril. Discard the bottle and sprayer after use or within 8 hours of preparation.
• Lie down in a quiet, dark room for a while after you use Migranal (Dihydroergotamine-nasal). This may help with your treatment.

Store the product at room temperature.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.