Overuse of migraine drug increases cardiac risk

	Tweet

The overuse of ergotamine increases the risk of cardiovascular complications, such as heart attack and stroke, among migraine patients who are taking drugs for cardiovascular disease, according to a report in the journal Neurology. However, this effect was not seen with triptans, another class of drugs frequently prescribed for migraine.

Ergotamine, which belongs to a group of drugs referred to as ergot alkaloids, is prescribed to patients with migraine or other types of severe headache under the trade name Ergomar and several others. It is also available in combination with caffeine, under trade names such as Wigraine and Cafergot, and with other drugs.

Because ergotamine causes blood vessels to narrow, serious side effects may develop as the flow of blood carrying oxygen to the body’s tissues is diminished.

Prescribers sometimes weigh the low risk of cardiovascular events against the increased quality of life from pain relief when selecting a migraine drug for patients with cardiovascular risk factors, Dr. Elisabeth A. Wammes-van der Heijden told Reuters Health. “In this case, we would recommend prescribing a triptan and not ergotamine.”

Wammes-van der Heijden from Utrecht University in the Netherlands and colleagues used a pharmacy dispensing database to identify patients prescribed a triptan or ergotamine. They then found 188 migraine patients who had been hospitalized for a cardiovascular complication and matched them to 689 comparison patients (controls).

In general, the overuse of antimigraine drugs did not increase the risk of hospitalization due to cardiovascular events. However, the overuse of antimigraine drugs among the subset of patients who were also using cardiovascular drugs more than doubled their already elevated risk of complications, the results indicate.

This effect was seen with the simultaneous use of cardiovascular drugs and the overuse of ergotamine, but not with the overuse of triptans.

“If a doctor decides to prescribe an antimigraine drug to a patient with cardiovascular risk factors, in spite of this fact, we indeed would recommend a triptan and not ergotamine,” Wammes-van der Heijden said.

The study did not distinguish between patients with low or high cardiovascular risk, Wammes-van der Heijden cautioned. “This means that the prescriber still has to carefully evaluate possible adverse effects before prescribing ergotamine or triptans to a patient.”

SOURCE: Neurology October 2006.

RELATED STORIES:
Scientists turn skin cells into beating heart muscle   Too many people get angioplasties, study suggests   New Blood Thinner May Lower Chances of Clots in High-Risk Heart Patients: FDA   Heart Damage After Chemo Linked to Stress in Cardiac Cells   What’s good or bad for the heart, may be the same for the brain   Warfarin in Heart Failure   Increased Sudden Cardiac Death Rate Among HIV Patients   Air pollution level changes in Beijing linked with biomarkers of cardiovascular disease   Lack of basic evidence hampering prevention of sudden heart attacks in sport   Blacks Less Likely to Get Help on Scene After Cardiac Arrest: Study   Heart attack patients taken to PCI hospitals first treated faster   Cameron Health’s under-skin ICD safe, effective

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]