Cafergot Special Precautions

Cafergot is not recommended in patients aged under 12 years or over 65 years.
Cafergot is only indicated for the treatment of acute migraine attacks and not for prevention.
Continued daily use of Cafergot or it's use in excess of the recommended doses must be avoided since it may cause vasospasm.
If contrary to recommendations (see PRECAUTIONS) ergotamine-containing drugs including Cafergot are used excessively over years, they may induce fibrotic changes, in particular of the pleura and the retroperitoneum. There have also been rare reports of fibrotic changes of the cardiac valves.
Treated patients must be informed of the maximum dose that should not be exceeded and of the initial symptoms of overdose: ischaemic and trophic episodes in the extremities: onset of paresthesia (numbness, tingling), pain or vasoconstriction, even at the usual doses, must be investigated, nausea and vomiting not related to the migraine, symptoms of myocardial ischaemia (precordialgia).
As soon as the symptoms of overdose appear, treatment should be discontinued and the patient should consult his or her doctor as soon as possible.
Long-term or excessive use is contraindicated as it may lead to: fibrosis (especially pleural or retroperitoneal). Rare cases of cardiac valve fibrosis have been reported.
Ergotism including severe symptoms of peripheral blood vessel vasoconstriction, which may be potentially fatal.
Patients suffering from mild to moderate liver failure, especially those with hepatic cholestasis, must receive suitable follow-up.
The excessive use of antimigraine treatment may lead to the onset of chronic daily headaches, requiring the temporary withdrawal of treatment.
Athletes' attention must be drawn to the fact that this medicinal product contains ergotamine, which is included in the list of doping substances.
The concomitant administration of this medicinal product and dopaminergic ergot alkaloids, alpha sympathomimetics (oral and/or nasal route), indirect sympathomimetics, crizotinib, idelalisib or enoxacin is inadvisable (see Interactions).
Effects on ability to drive and use machines: Patients experiencing dizziness should not drive or operate machinery.