Comparative Pharmacology
Head-to-head clinical analysis: D H E 45 versus MAXALT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: D H E 45 versus MAXALT.
D.H.E. 45 vs MAXALT
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Dihydroergotamine (DHE) is a semi-synthetic ergot alkaloid that acts as an agonist at serotonin (5-HT1B/1D) receptors, causing vasoconstriction of intracranial blood vessels and inhibition of trigeminal nerve transmission, thereby aborting migraine attacks. It also has high affinity for alpha-adrenergic receptors and moderate affinity for dopamine D2 receptors.
Selective serotonin 5-HT1B/1D receptor agonist; causes vasoconstriction of cranial arteries and inhibits trigeminal nerve signaling.
1 mg intramuscularly or subcutaneously at first sign of headache, repeat hourly up to 3 mg per day, maximum 6 mg per week.
5 mg or 10 mg orally at onset of migraine; maximum 30 mg in 24 hours (two doses with at least 2 hours between them).
None Documented
None Documented
2.5 hours (range 2-3.5 hours) for ergotamine; clinical context: short half-life supports its use in acute migraine, but frequent dosing risks ergotism.
2-3 hours in plasma; clinical effect correlates with distribution to CNS rather than plasma half-life.
Primarily hepatic metabolism; renal excretion of metabolites accounts for approximately 90% of elimination, with 10% fecal.
Renal (60% as unchanged drug and metabolites) and fecal (40% primarily as metabolites).
Category C
Category C
Antimigraine Agent
Antimigraine Agent