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  药店国别: 欧洲共同体药房
产地国家: 欧洲共同体国家
所属类别: 神经系统药物->镇痛药
处方药:处方药
包装规格: 2.5毫克/片 30片/盒
计价单位:
  点击放大  
生产厂家中文参考译名:
爱尔兰AMDIPHARM公司
生产厂家英文名:
AMDIPHARM LTD, IRELAND
该药品相关信息网址1:
http://www.virtualmedicalcentre.com/drugs.asp?drugid=2936&title=Dihydergot
原产地英文商品名:
DIHYDERGOT 2.5mg/tab 30tabs/box
原产地英文药品名:
DIHYDROERGOTAMINE
中文参考商品译名:
DIHYDERGOT 2.5毫克/片 30片/盒
中文参考药品译名:
双氢麦角胺
原产地国家批准上市年份:
0000/00/00
英文适应病症1:
Migraine
英文适应病症2:
Vascular headache
英文适应病症3:
Limb spasticity
英文适应病症4:
Herpes zoster
英文适应病症5:
Chronic constipation
临床试验期:
完成
中文适应病症参考翻译1:
偏头痛
中文适应病症参考翻译2:
血管性头痛
中文适应病症参考翻译3:
肢端痉挛
中文适应病症参考翻译4:
带状疱疹
中文适应病症参考翻译5:
慢性便秘
药品信息:

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 详细处方信息以本药内容附件PDF文件(20121519343315.pdf)的“原文Priscribing Information”为准
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部分中文双氢麦角胺处方资料(仅供参考)

双氢麦角胺
分类名称
一级分类:神经系统药物 二级分类:抗偏头痛药物
 
药品英文名
Dihydroergotamine
 
药品别名
氢麦角胺、甲磺双麦角胺、甲磺双氢麦角胺、双氢麦角胺甲磺酸盐、二氢麦角胺、Dihydroergotamine Mesilate、Dihydergot、Seglor
 
药物剂型
1.片剂:1mg;2.注射剂:1mg(1ml)。
 
药理作用
为α-受体拮抗药,作用类似麦角碱,对血管运动中枢的抑制作用比麦角胺强,降低血管紧张度,能缓解脑血管痉挛,并使血压下降,但缩宫作用减弱。
 
药动学
本药口服吸收差,肌内注射后15~30min起效,作用维持3~4h。静脉注射10μg/kg的双氢麦角碱后,15min达血药峰浓度,为15.6ng/ml,2h后降至1ng/ml。皮下注射双氢麦角碱0.5mg,42min后血药浓度达峰值1.74ng/ml。口服双氢麦角碱10、20、30mg后大约30min达到血药浓度峰值,分别是0.2ng/ml、0.6ng/ml和1ng/ml。鼻内单剂使用双氢麦角碱1mg,54min血药浓度达峰值1ng/ml。口服1~2.5mg,每天3次,5天后,可望达到稳态血浆浓度2~5ng/ml。口服生物利用度低,小于1%(0.17%~0.94%)。鼻内单剂使用双氢麦角碱1mg,相对生物利用度是38.4%。总蛋白结合率为93%。表观分布容积(Vd)为14.5L/kg。双氢麦角碱在肝脏被广泛地代谢,口服后,有首过效应。代谢产物有5-羟基-双氢麦角碱(有活性)、氢麦角酸(活性未知)、氢麦角酸酰胺(活性未知)。本药主要通过胆汁经粪便排泄,也可通过乳汁排泄,只有很少量的双氢麦角碱及其代谢产物通过尿液排泄。
 
适应证
用于偏头痛急性发作和血管性头痛、肢端痉挛、带状疱疹和慢性便秘。
 
禁忌证
1.对麦角生物碱过敏者;2.周围血管病变;3.心肌梗死;4.未控制的高血压;5.严重肝、肾功能不全;6.持续低血压或休克;7.败血症;8.同时使用其他血管收缩药或升压药(可引起极度高血压);9.24h内使用过其他特殊药物如麦角类、美西麦角、5-HT1拮抗药(如舒马坦)等;10.血管外科手术后;11.孕妇和哺乳期妇女。
 
注意事项
1.慎用:(1)对其他麦角碱药物曾产生过依赖性的患者;(2)已知有脑血管意外的危险因素时。2.药物对妊娠的影响:本药有催产作用和致畸性。3.药物对哺乳的影响:麦角类药可分泌入乳汁,并使哺乳婴儿出现呕吐、腹泻、脉弱、血压不稳等症状。4.因本药口服吸收不佳,治疗偏头痛多采用注射。但冠心病患者应口服给药。5.应避免持续使用本药,以防蓄积过量。
 
不良反应
1.心血管系统:可致血管痉挛,导致四肢疼痛、跛行,可出现短暂的心动过速,使用大剂量的双氢麦角碱(或长期使用)后,可出现麦角中毒症状,表现为严重的肌肉疼痛、心绞痛、短暂的窦性心动过速和心动过缓及高血压或低血压。2.中枢神经系统:当给予大剂量和(或)长期使用时,可引起四肢及手指和脚趾感觉异常、下肢无力、头痛、意识模糊、嗜睡,并可能出现惊厥。皮肤发冷或四肢麻木和针刺感是即将出现麦角中毒的标志。3.消化系统:大剂量或长期使用本药时,可出现恶心、呕吐、上腹不适、腹泻、便秘等症状。有报道,联用本药与肝素预防深静脉血栓形成时,结果出现肠缺血和继发坏死。肾毒性:据报道,本药可导致急性肾衰竭,表现为皮肤色素沉着和表皮脱落、指甲变白,尿多或者尿少,血浆的尿素氮和肌酐明显升高。经治疗,患者在3周内临床康复。5.眼慢性麦角中毒时可出现瞳孔缩小。6.呼吸系统:有报道长期服用本药可出现胸膜增厚或渗液、间质性肺炎。停药后,症状均可消失。7.骨骼肌:反复静脉注射本药治疗每天发作的慢性头痛,可出现痉挛性腿痛。8.皮肤:(1)慢性麦角中毒时可见局部水肿和瘙痒症;(2)周围血管疾病患者可见外周坏疽的症状;(3)联合使用肝素预防深静脉血栓形成,可见皮肤和肌肉坏死。
 
用法用量
1.口服:每次1~3mg,每天2~3次。2.肌内注射:每次1~2mg,每天1~2次。
 
药物相应作用
1.本药与可卡因、肾上腺素、去甲肾上腺素、利多卡因、氯雷他定、米多君、二醋酸麦迪霉素、环己丙甲胺、伪麻黄碱、阿托那韦、沙拉新等药联用,可能导致血压骤升,可能的机制有药理协同作用,部分药理机制仍不清楚。2.本药与佐米曲坦,舒马曲坦,利扎曲坦、那拉曲坦联用,血管痉挛反应延长,可能的机制是血管收缩作用的协同。3.本药与右苯丙胺、西布曲明联用,可致血清素综合征,表现为意识错乱、精神状态改变、出汗、震颤、肌阵挛、寒战、反射亢进、高血压,可能的机制为增加了突触的血清素水平,使得血清素受体过度刺激。4.本药与安泼那韦;那非那韦、沙奎那韦、印地那韦、硝酸甘油、地拉夫定、克拉霉素、地红霉素、伊法维仑、红霉素,红霉素-磺胺异噁唑、醋竹桃霉素等药联用,可致麦角中毒或者增加麦角中毒的危险,表现为恶心、呕吐、血管痉挛性缺血等,可能的机制是减少于双氢麦角碱在体内的代谢。
 
专家点评
作用类似麦角碱。对血管运动中枢的抑制作用比麦角胺强,但催产作用减弱。

Dihydergot
Generic Name: Dihydroergotamine mesylate
Product Name: Dihydergot

Indication of Dihydergot:
Dihydergot is used to relieve migraine and cluster headache. It is also used to treat severe disabling orthostatic hypotension.

Action of Dihydergot:
Dihydergot contains the active ingredient dihydroergotamine. It belongs to a group of medicines known as the "ergot alkaloids." Dihydergot has complex pharmacological effects. It has both the stimulating and blocking effects on both alpha-adrenergic and serotonergic receptors. 

During migraine attacks, the small blood vessels in your brain swell and cause temporary change in size. This results in pain and visual disturbance. Dihydergot stops the atack by causing the blood vessels to shrink back to its original size. Dihydergot is only used to treat migraine attacks. It is not used to prevent attacks from happening.

Dihydergot is also used in adults to prevent a sudden, sharp drop in blood pressure that happens in some people when they stand up after sitting or lying down for a long period of time. This condition, called orthostatic hypotension, can cause severe, disabling attacks of dizziness and lightheadedness, sometimes with fainting.

Dose advice of Dihydergot:
Dose Information
Dihydergot is available as an injection and in tablet form.

How much Dihydergot is given
Acute migraine attack: Oral dihydroergotamine is not recommended for acute migraine attack because efficacy has not been demonstrated.

Severe disabling low blood pressure in adults: the first dose of Dihydergot is usually given by slow injection into a vein. After that, 1/2 to 1 tablet can be taken three times a day. If neccessary, the dose is adjusted weekly depending on your clinical response. Doses of up to 40 to 60 mg a day may be needed for some people. When treatment is needed for a prolonged period, it may be possible to reduce the daily dose. 

Children under 12 years. One-third to two-thirds of the adult dosage according to age.

Important notes
1.Do not use sumatriptan, naratriptan or zolmitriptan or any medicine containing ergot alkaloids (e.g. Cafergot or Ergodryl) at the same time as you have Dihydergot. You must wait at least 24 hours before you use any other medicine containing ergot alkaloids, sumitriptan, naratriptan or zolmitriptan.
2.Do not have more than the maximum recommended daily and weekly doses of Dihydergot. Do not continue treatment for longer than your doctor recommends.
3.If you forget to take the tablets, you may take your missed dose as soon as you remember if it is more than 4 hours until your next dose is due. Otherwise, you should skip the missed dose. Then, you may take your next dose as per normal. Do not take a double dose to make up for the one that you missed as this may increase the chance of you getting an unwanted side effect.
4.Do not use Dihydergot to prevent a migraine attack from happening. This medicine should only be used to treat a migraine once it has started.
5.Avoid drinking grapefruit juice while you are having Dihydergot. Grapefruit juice may interfere with the action of Dihydergot in your body.
6.Dihydergot may make you feel dizzy. You should avoid driving, operating machinery or doing jobs that require you to be alert until you know how Dihydergot affects you.

Contraindications 
Before you have Dihydergot, you must ensure that you do not 
•have allergic reaction to dihydroergotamine, the active ingredient in Dihydergot  and any other ergot alkaloids (for instance, Cafergot, Deseril, Ergodryl, Ergometrine, Kripton, Parlodel, Syntometrine)
•have heart problems such as uncontrolled angina, heart attack and severe high blood pressure
•have poor blood circulation or other blood vessel disorders
•suffer from severe liver disease
•have any serious infection
•take ketoconazole, itraconazole, erythromycin or clarithromycin
•take HIV/AIDS drugs (such as ritonavir, nelfinavir, indinavir or delvaridine)

Precautions
Before you start to have it, you must inform your doctor
•if you have liver problems or severe kidney problems as your doctor may want to take special precautions during your treatment.
•if you smoke as nicotine in cigarettes may increase the chance of you experiencing excessive constriction of blood vessels, an unwanted effects called "ergotism".
•if you are lactose intolerant as dihydergot tablets contain lactose.
•if you are taking other medicines, including herbal supplements and over-the-counter medicines that you can obtain from pharmacy, supermarket or health food shops. You may need to take different amounts of your medicines or to take different medicines while you are having Dihydergot. 

Use in pregnancy (Category C)
Do not have Dihydergot if you are pregnant or intend to become pregnant. This medicine may affect your developing baby if you have it while you are pregnant.

Use in breastfeeding
The active ingredient in Dihydergot may pass into breast milk and may affect your baby. However, one or two doses are unlikely to be of concern. You should check with your doctor if Dihydergot is indicated while you are breastfeeding.

Schedule of Dihydergot:
S4

Common side effects of Dihydergot:
All medicines can have side effects. Common side effects are those which occur in more than 1% patients given Dihydergot:
•nausea and vomiting
•abdominal pain
•muscle pain
•weakness
•diarrhoea
•headache
•numbness and tingling
•cold extremities
•dizziness
•fast, slow or irregular heart beat
•shaking or tremor
•feeling anxious or restless
•dry mouth
•flushing of the skin

Do not be alarmed by the possible side effects listed. The are usually mild and you may not even experience any of them. However, do not hesitate to see your doctor if they worry you.

Uncommon side effects of Dihydergot:
Do not be alarmed by the list of side effects below. They are generally uncommon (less than 1%) and you may not experience any of them. However, if you feel unwell after taking Dihydergot or notice any of the following symptoms, you should tell your doctor immediately.
•signs of allergy such as rash, itching or hives on the skin, swelling of the face, lips, tongue or other part of the body, wheezing or troubled breathing
•signs of "ergotism" (excessive constriction of blood vessels) such as numbness, coldness, tingling or a pale or bluish colour in the fingers or toes, pain or spasms in muscles, weakness in the lower legs, chest pain
•pain in the lower back or side, associated with difficulty in passing urine or pain on urinating, which may be a sign of a thickening of the abdominal lining that can cause obstruction of the urinary tract
•shortness of breath, dry cough, pain in the chest or rib area
•seizures

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 详细处方信息以本药内容附件PDF文件(20121519343315.pdf)的“原文Priscribing Information”为准
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更新日期: 2012-1-6
附件:
 
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