dihydroergotamine mesylate injection / Generic mfg. - LARVOL DELTA

Dihydroergotamine Intranasal Powder for Acute Migraine Treatment. (PubMed, Ann Pharmacother) - "The design and pharmacokinetic properties of DHE intranasal powder appear to offer advantages over other DHE dosage forms, but current data do not support its use as a first-line agent for the treatment of migraine headaches."

Journal • Review • CNS Disorders • Migraine • Pain

Study participant impression of use and satisfaction with STS101 (dihydroergotamine nasal powder): Results from the open-label ASCEND acute migraine study. (PubMed, Headache) - P3 | "Participant impression data through 12 months suggest that STS101 was generally perceived as favorable by participants on multiple attributes. Most considered STS101 easy to use and indicated they would be likely to use the product if it were available. Exploratory efficacy evaluations indicated beneficial effects."

Journal • CNS Disorders • Migraine • Pain

Virtual screening of drugs against multiple targets of Alzheimer's disease. (PubMed, J Alzheimers Dis) - "BackgroundDrug repurposing offers a rapid, cost-effective approach for discovering therapies against multiple targets.ObjectiveHere, we screen virtual ligand libraries consisting of 3468 approved drugs against 11 protein targets associated with Alzheimer's disease (AD).MethodsWe employ blind molecular docking, and target amyloid-β (Aβ), microtubule-associated protein tau (MAPT), Apolipoprotein E4 (APOE4), acetylcholinesterase (AChE), butyrylcholinesterase (BChE), amyloid-β protein precursor (AβPP), β-secretase (BACE1), brain-derived neurotrophic factor (BDNF), presenilin 1 (PSEN1) and 2 (PSEN2), and α-synuclein (SNCA) proteins using AutoDock Vina.ResultsNotably, multitarget binding recurs among the top-10 ligands with Ergotamine and Dihydroergotamine potentially binding 8; Dutasteride 7; Drospirenone and Nilotinib 6; Adapalene and Conivaptan 5; Bromocriptine 4; and Rolapitant, Irinotecan, Plerixafor, Saquinavir, and Telmisartan 3, out of 11 protein targets. Likewise,..."

Journal • Alzheimer's Disease • Cardiovascular • CNS Disorders • Hypertension • Inflammation • Pain • APOE • BDNF • MAPT • SNCA

THE LONG-TERM IMPACT OF COVID-19 ON ADMISSIONS FOR MIGRAINE WITH DHE: A DESCRIPTIVE ANALYSIS (WCN 2025) - "Dihydroergotamine (DHE) is a key treatment for refractory migraine, but the pandemic's impact on its use is unclear... A significant and sustained decline in admissions for treatment of migraine with DHE was observed at the onset, during and after the COVID-19 pandemic. While this trend may reflect broader changes in healthcare delivery and patient care-seeking behaviors triggered at least in-part by the pandemic, further research is needed to determine the specific factors contributing to this decline, including potential shifts in prescribing patterns, patient preferences, and healthcare accessibility."

CNS Disorders • Migraine • Pain

INTRAVENOUS TREATMENTS FOR HEADACHE DISORDERS (WCN 2025) - "In some places, ketorolac is favoured, elsewhere chlorpromazine or prochlorperazine and there are several other options such as aspirin and valproate...The agents most often used include dihydroergotamine (DHE), lidocaine and ketamine...Recently, a CGRP antibody given intravenously for migraine prophylaxis has become available: eptinezumab...DHE has at times been used in cluster headache. Some of the evidence for these treatments and some practical advice about them will be discussed."

CNS Disorders • Migraine • Pain

Exploring critical hub genes and potential drug candidates for PCOS: A systems biology approach. (PubMed, Reprod Biol) - "Results from the molecular docking study indicated that three drugs, namely Ponatinib, Dihydroergotamine, and Paliperidone, exhibited the lowest binding affinity energy and displayed the highest interaction with the most critical hub genes identified through the PPI network analysis (WNT5A, SERPINE1, and CXCR4). However, it is important to note that further research and well-designed clinical trials are necessary, as there is limited evidence from small-population clinical trials regarding the repurposing of drugs for PCOS. Advancements in PCOS knowledge will aid in the development of innovative medications for the disorder."

Journal • Endocrine Disorders • Polycystic Ovary Syndrome • CXCR4 • SERPINE1

Response to intravenous dihydroergotamine (DHE) for the treatment of refractory chronic migraine in adolescent patients (IHC 2025) - "Pre-infusion ondansetron 150 mcg/kg and prochlorperazine 5 mg/kg were administered PRN...For management, 54% (14/26) used sumatriptan,19% (5/26) used rizatriptan, 23% (6/26) used zolmitriptan, and 4% (1/26) used eletriptan. Preventively, 31% (8/26) had used propranolol, 23% (6/26) topiramate, 23% (6/26) amitriptyline, and 23% (6/26) pizotifen...This may include infusion slowing and increasing anti-emetic breadth and doses. Larger longer-term follow up studies are needed."

Clinical • CNS Disorders • Migraine

Research and Management Gaps in Cluster Headache Through Patient Perspectives (IHC 2025) - "Table 1. Treatment methods used for Cluster Headache management (N=137) Treatment Types N (%) Acute Prescription medications (e.g., sumatriptan, dihydroergotamine, zolmitriptan) 118 (86%) Over-the-counter pain medications (e.g., paracetamol, ibuprofen) 109 (80%) Oxygen therapy 68 (50%) Transitional Prednisolone 69 (50%) Nerve Block 44 (32%) Preventative Prescription medications (e.g., verapamil, lithium carbonate, divalproex sodium, melatonin, topiramate) 99 (72%) Lifestyle changes (e.g., sleep, diet) 89 (65%) Non-invasive vagal nerve stimulation 19 (14%) Conclusion Survey participants with cluster headache highlighted treatment limitations, identified key research priorities, and showed interest in clinical trials, particularly for psilocybin and combination therapies."

Clinical • Migraine

Pharmacotherapy Management of Acute Migraine in the Emergency Department. (PubMed, Adv Emerg Nurs J) - "Rescue therapies such as dexamethasone, valproic acid, magnesium sulfate, and, in rare cases, dihydroergotamine and caffeine, are indicated for refractory or recurrent symptoms. Special populations, including pregnant individuals, pediatric, and geriatric patients, as well as those with cardiovascular disease, require individualized management. It is critical for ED personnel to provide not only optimal pharmacotherapy but also safe medication administration, astute monitoring for adverse effects, and the provision of discharge education to prevent migraine recurrence and ensure outpatient follow-up."

Journal • Cardiovascular • CNS Disorders • Geriatric Disorders • Migraine • Pain • Pediatrics

Atzumi for migraine: a new era of needle-free dihydroergotamine delivery. (PubMed, Ann Med Surg (Lond)) - "Atzumi, a dihydroergotamine mesylate nasal powder, recently received U.S. Food and Drug Administration approval and represents a promising alternative. Data from both early pharmacokinetic testing and a long-term safety study suggest that it works quickly and is generally well tolerated. Patients experienced meaningful relief, often without needing backup medications, and side effects were reported infrequently."

Journal • CNS Disorders • Migraine • Pain

First in human study to evaluate pharmacokinetics, safety and tolerability of a novel in-development dihydroergotamine mesylate (DHE) inhalation powder delivered via a multidose dry powder inhaler (DPI) (AHS 2025) - "Background: Migraine remains a serious cause of disability with significant financial and socioeconomic burden and 37.4%–74.1% still report dissatisfaction with their current acute treatment.3,4 Reasons for this include narrow treatment window, GI dysmotility leading to poor oral absorption, slow speed of onset, high pain recurrence and poor tolerability.3,4 Dihydroergotamine (DHE), supported by over 70 years of clinical practice data, is established as safe and effective in acute treatment of migraine.1 Intravenous (IV) DHE provides fast onset, sustained efficacy and minimal risk of medication-overuse headache.1,7 However, its use is limited by poor tolerability (such as nausea and vomiting) and in-hospital administration.1,7 Two approved DHE intranasal (IN) formulations (Migranal® and Trudhesa®) address some of the limitations of the IV DHE.5–7 However, Migranal®, nasal spray delivering to lower nasal space, has limitations of low bioavailability,..."

Clinical • P1 data • PK/PD data • CNS Disorders • Migraine • Pain

Aprepitant for primary nausea control for pediatric patients during repetitive dihydroergotamine infusions (AHS 2025) - "The data suggests that patients who received aprepitant were more likely to receive additional anti-emetics during DHE treatments. Given that this study is a retrospective cohort study at a single institution, more studies are necessary in order to determine the external validity of this study. It is important to control nausea in patients receiving DHE so they are able to complete treatment for migraine and there appears to be a trend of an increased number of patients who completed the DHE protocol when administered with aprepitant."

Clinical • CNS Disorders • Migraine • Pain

Disparities in inpatient dihydroergotamine administration in pediatric patients with headache at the Children's Hospital of Philadelphia (AHS 2025) - "Non-Hispanic and White patients had higher odds of receiving DHE compared to non-Hispanic patients and those of other races who were diagnosed with migraine. For certain minoritized populations, sample sizes were likely not large enough to obtain statistically significant differences. We must conduct further investigation to understand potential reasons for such disparities which are likely related to inequity in rates of admission for migraine and rates of IV medication both of which have been demonstrated in our previous work."

Clinical • CNS Disorders • Migraine • Pain

The long-term impact of COVID-19 on admissions for migraine with DHE: A descriptive analysis (AHS 2025) - "One Sentence Summary: A significant decline in admissions for the treatment of migraine with dihydroergotamine (DHE) was observed during the COVID-19 pandemic and remained markedly lower than pre-pandemic levels in subsequent years... A significant and sustained decline in admissions for treatment of migraine with DHE was observed at the onset, during and after the COVID-19 pandemic. While this trend may reflect broader changes in healthcare delivery and patient care-seeking behaviors triggered at least in-part by the pandemic, further research is needed to determine the specific factors contributing to this decline, including potential shifts in prescribing patterns, patient preferences, and healthcare accessibility. FIGURE 1."

CNS Disorders • Migraine • Pain

What to Do When Prior Acute Migraine Treatments Fail: Underlying Mechanisms and Treatment Approaches (AHS 2025) - "Current therapeutic options for acute migraine treatment include new drug classes (gepants, ditans), as well as novel delivery options of established drug classes (dihydroergotamine, triptans, NSAIDs). A newly approved therapeutic option is a multi-mechanistic approach that targets several pathophysiologic mechanisms through a novel formulation of meloxicam and rizatriptan combined in the same tablet. The symposium will highlight the pathophysiologic processes and multi-mechanistic approaches for acute treatment of migraine, including therapies to consider when previous acute treatments fail or when response is inadequate.Educational ObjectivesUpon completion of this activity, participants should be able to:• Identify central, peripheral, neuronal, and vascular pathophysiologic mechanisms involved in acute migraine pain• Explain the scientific rationale for multi-mechanistic targeting of pathophysiologic mechanisms of acute migraine in patients with inadequate response..."

CNS Disorders • Migraine • Pain

Peripheral blood immune landscape and NXPE3 as a novel biomarker for hypertensive intracerebral hemorrhage risk prediction and targeted therapy. (PubMed, Imeta) - "Molecular docking and simulation results demonstrated that NXPE3 is a potential therapeutic target, and dihydroergotamine (DHE) exhibits a strong binding affinity to NXPE3. In vivo experiments indicated that DHE can reduce the incidence of spontaneous ICH and modulate the immune-inflammatory response. These results support DHE targeting NXPE3 as a potential therapeutic strategy for hypertension-related ICH."

Biomarker • Journal • Cardiovascular • Cerebral Hemorrhage • Hematological Disorders • Hypertension • Inflammation

Myocardial Infarction With Nonobstructive Coronary Arteries: A Significant Adverse Effect of Dihydroergotamine. (PubMed, Cureus) - "Despite long-term use without prior adverse effects, our patient developed MINOCA after receiving DHE to treat migraine attacks, highlighting the unpredictable nature of DHE's vasoconstrictive effects and underscoring the need for heightened clinical vigilance, especially in patients with underlying cardiovascular risk factors. Given the diagnostic and prognostic ambiguity surrounding MINOCA, this case contributes to the growing body of literature advocating for individualized risk assessment and cautious DHE administration."

Adverse events • Journal • Acute Coronary Syndrome • Cardiovascular • CNS Disorders • Inflammation • Migraine • Myocardial Infarction • Pain

In silico drug repurposing for potential HPV-induced skin wart treatment - A comparative transcriptome analysis. (PubMed, J Genet Eng Biotechnol) - "Dihydroergotamine can be repurposed as a potential drug in the treatment of skin warts by targeting Integrin Alpha-X protein."

Journal • Cervical Cancer • Dermatology • Human Papillomavirus Infection • Infectious Disease • Oncology • Solid Tumor • ITGAX

A fixed-dose combination of meloxicam and rizatriptan (Symbravo) for migraine. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • CNS Disorders • Migraine • Pain

Tolerability of repetitive dihydroergotamine infusions paired with an adjustment in preventive treatment strategy in chronic headache disorders in children and youth. (PubMed, J Headache Pain) - "Repetitive DHE infusions followed by preventive treatment adjustment was well tolerated and significantly reduced headache frequency, baseline intensity, number of severe days and/or acute medication usage in children and youth with refractory headache disorders."

Journal • CNS Disorders • Migraine • Pain • Pediatrics

Polypharmacy and Trends in Pharmacologic Management in Patients with Refractory Spontaneous Intracranial Hypotension (SIH) (AAN 2025) - "Prescription medications were categorized by class: triptans, dihydroergotamines, anti-CGRP monoclonal antibodies, CGRP antagonists, NSAIDs, antidepressants, antihypertensives, and anticonvulsants...Medication trials for refractory SIH may contribute to polypharmacy in a subset of patients. Further investigation into the impact of polypharmacy in SIH patients is warranted."

Clinical • CNS Disorders • Hypotension • Migraine • Pain

Identification of potential diagnostic targets and therapeutic strategies for anoikis-related biomarkers in lung squamous cell carcinoma using machine learning and computational virtual screening. (PubMed, Front Pharmacol) - "Dihydroergotamine exhibited significant anti-LUSC activity and holds promise as a potential therapeutic agent. CSNK2A1 emerged as a robust candidate for early diagnosis and a therapeutic target in LUSC."

Biomarker • Journal • Lung Cancer • Non Small Cell Lung Cancer • Oncology • Solid Tumor • Squamous Cell Carcinoma

Exploring bacterial key genes and therapeutic agents for breast cancer among the Ghanaian female population: Insights from In Silico analyses. (PubMed, PLoS One) - "Subsequently, the bKG-guided top ranked 10 drug molecules Digitoxin, Digoxin, Ledipasvir, Suramin, Ergotamine, Venetoclax, Nilotinib, Conivaptan, Dihydroergotamine, and Elbasvir were identified using molecular docking analysis. The stability of top-ranked three drug-target complexes (Digitoxin-pykA, Digoxin-mdh, and Ledipasvir-pgi) were confirmed through the molecular dynamics simulation studies. Therefore, these findings might be useful resources to the wet-lab researchers for further experimental validation on bacterial therapies against BC."

Journal • Breast Cancer • Infectious Disease • Oncology • Solid Tumor

Relationship of dihydroergotamine pharmacokinetics, clinical efficacy, and nausea-A narrative review. (PubMed, Headache) - "The maximum concentration and AUC over the first 30 min following DHE administration were associated with increasing rates of 2hPR and a Cmax below ~2500 pg/mL was associated with low incidences of nausea. We suggest that this may be an optimal profile for a DHE delivery form. Further research to test this hypothesis is warranted."

Journal • PK/PD data • Review • CNS Disorders • Migraine • Pain

Facial Nerve Palsy, Left Upper Extremity Weakness, and the Absence of Papilledema in an 8-year-old Child with Idiopathic Intracranial Hypertension: A Case Report (ANA 2024) - "The patient's occipital pain was minimally responsive to over-the-counter anti-inflammatories, migraine cocktails, and abortive migraine treatment with dihydroergotamine...She was prescribed maintenance acetazolamide and instructed to follow outpatient with pediatric neurology for management of her newly diagnosed IIH. IIH cannot definitively be excluded in the absence of papilledema or in the presence of atypical features, such as an isolated facial nerve palsy or polyradiculopathy. A high index of suspicion for IIH should remain, particularly in children, as it is a sight-threatening condition if left untreated."

Case report • Clinical • CNS Disorders • Migraine • Pain