Understanding Migraines

If you suffer from migraines, you’re not alone. Migraines affect more than 37 million Americans.1

  • 1 in every 4 households in the United States has a migraine sufferer2
  • Migraines are most commonly experienced between the ages of 35 and 551
  • 7 out of 10 migraine sufferers are women1
  • Not all migraines respond to the most commonly prescribed medications, called triptans3
  • It is not uncommon for migraine sufferers to try 2 or even 3 prescription and over-the-counter medications before finding relief3

Most migraines are characterized by certain types of headache pain with or without other symptoms. One-sided, throbbing, pulsating head pain that can be accompanied by nausea, vomiting, and/or sensitivity to light and noise is typical of migraines. Some people may also experience aura, or visual displays, before or during attacks.4

What triggers migraine attacks?

Sometimes you just don’t know how a particular migraine attack got started. However, people frequently get a sense of what is likely to set off their migraines. There are many common triggers for people who get migraines, including5 :

Sensations
  • Bright lights
  • Certain odors or perfumes
  • Loud noises
Body changes
  • Changes in hormonal levels (which can occur during a woman’s menstrual cycle or with the use of birth control pills)
Behavioral factors
  • Changes in sleep patterns
  • Exercise
  • Physical or emotional stress
  • Smoking or exposure to smoke
Dietary intake
  • Alcohol
  • Missed meals
  • Certain foods (see chart below)

Partial List of Common Foods That May Trigger Migraine Attacks5

  • Processed, fermented, pickled, or marinated foods
  • Baked goods
  • Chocolate
  • Dairy products
  • Food containing additives such as monosodium glutamate
  • Foods containing tyramine, such as red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
  • Fruits such as avocado, banana, and citrus
  • Meats containing nitrates such as bacon, hot dogs, salami, and cured foods
  • Nuts, including peanut butter
  • Onions

 

INDICATION

Migranal® (dihydroergotamine mesylate, USP) Nasal Spray is used to treat an active migraine headache with or without aura. Do not use it to try to prevent a migraine if you have no symptoms, to treat a common tension headache, or to treat a migraine that is not typical of your usual migraine.

IMPORTANT SAFETY INFORMATION

WARNING

Serious or potentially life-threatening reductions in blood flow to the brain or extremities due to interactions between dihydroergotamine (the active ingredient in Migranal Nasal Spray) and protease inhibitors and macrolide antibiotics have been reported rarely. As a result, these medications should not be taken together.

Do not use Migranal Nasal Spray if you:

  • Are pregnant or nursing
  • Have any disease affecting your heart, arteries, or blood circulation
  • Are taking certain anti-HIV medications known as protease inhibitors
  • Are taking a macrolide antibiotic such as troleandomycin, clarithromycin, or erythromycin
  • Have taken other medications for the treatment or prevention of migraine within the last 24 hours
  • Have severe liver or kidney disease
  • Experience hemiplegic or basilar migraines, which often cause paralysis or impairment of speech

Before taking Migranal Nasal Spray, tell your doctor if:

  • You have high blood pressure, chest pain, shortness of breath, heart disease; or risk factors for heart disease (such as high blood pressure, high cholesterol, obesity, diabetes, smoking, strong family history of heart disease or you are postmenopausal, or male over 40); or problems with blood circulation in your arms, legs, fingers, or toes
  • You are pregnant, planning to become pregnant or are nursing, or have ever stopped medication due to an allergy or bad reaction
  • You are taking any prescription or over-the-counter medications, including vitamins or herbal supplements
  • You have or had any disease of the liver or kidney
  • This headache is different from your usual migraine attacks

The use of Migranal Nasal Spray should not exceed dosing guidelines and should not be used on a daily basis.

Serious cardiac (heart) events, including some that have been fatal, have occurred following use of injectable dihydroergotamine, the active ingredient in Migranal Nasal Spray, but are extremely rare.

You may experience some nasal congestion or irritation, altered sense of taste, sore throat, nausea, vomiting, dizziness, and fatigue after using Migranal Nasal Spray. Contact your doctor immediately if you experience:

  • Numbness or tingling in your fingers and toes
  • Pain, tightness, or discomfort in your chest
  • Muscle pain or cramps in your arms and legs
  • Weakness in your legs
  • Temporary speeding or slowing of your heart rate
  • Swelling or itching
Please click here for full Prescribing Information, including Boxed Warning and Patient Information.
 
 
 

REFERENCES

  • 1.Migraine.com. Migraine statistics. https://migraine.com/migraine-statistics/. Accessed: May 25, 2016.
  • 2.National Headache Foundation. Press kits - AMS II fact sheet. http://www.headaches.org/press/NHF_Press_Kits/Press_Kits_-_AMS_II_Fact_Sheet#. Accessed November 26, 2013.
  • 3.Malik SN, Hopkins M, Young WB, Silberstein SD. Acute migraine treatment: patterns of use and satisfaction in a clinical population. Headache. 2006;46(5):773-780.
  • 4.National Headache Foundation. Press kits - AMPPS fact sheet. http://www.headaches.org/press/NHF_Press_Kits/Press_Kits_-_AMPPS_Fact_Sheet. Accessed November 26, 2013.
  • 5.National Institutes of Health. MedlinePlus. Migraine. http://www.nlm.nih.gov/medlineplus/ency/article/000709.htm. Accessed May 25, 2016.
  • 6.MIGRANAL [package insert]. Aliso Viejo, CA: Valeant Pharmaceuticals North America; 2014.
  • 7.Silberstein SD; US Headache Consortium. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2000;55(6):754-762.
  • 8. Marmura MJ, Silberstein SD, Schwedt TJ. The acute treatment of migraine in adults: the American Headache Society Evidence Assessment of migraine pharmacotherapies. Headache. 2015;55:3-20.

MIG.0023.USA.16

INDICATION

Migranal® (dihydroergotamine mesylate, USP) Nasal Spray is used to treat an active migraine headache with or without aura. Do not use it to try to prevent a migraine if you have no symptoms, to treat a common tension headache, or to treat a migraine that is not typical of your usual migraine.

IMPORTANT SAFETY INFORMATION

WARNING

Serious or potentially life-threatening reductions in blood flow to the brain or extremities due to interactions between dihydroergotamine (the active ingredient in Migranal Nasal Spray) and protease inhibitors and macrolide antibiotics have been reported rarely. As a result, these medications should not be taken together.

Do not use Migranal Nasal Spray if you:

  • Are pregnant or nursing
  • Have any disease affecting your heart, arteries, or blood circulation
  • Are taking certain anti-HIV medications known as protease inhibitors
  • Are taking a macrolide antibiotic such as troleandomycin, clarithromycin, or erythromycin
  • Have taken other medications for the treatment or prevention of migraine within the last 24 hours
  • Have severe liver or kidney disease
  • Experience hemiplegic or basilar migraines, which often cause paralysis or impairment of speech

Before taking Migranal Nasal Spray, tell your doctor if:

  • You have high blood pressure, chest pain, shortness of breath, heart disease; or risk factors for heart disease (such as high blood pressure, high cholesterol, obesity, diabetes, smoking, strong family history of heart disease or you are postmenopausal, or male over 40); or problems with blood circulation in your arms, legs, fingers, or toes
  • You are pregnant, planning to become pregnant or are nursing, or have ever stopped medication due to an allergy or bad reaction
  • You are taking any prescription or over-the-counter medications, including vitamins or herbal supplements
  • You have or had any disease of the liver or kidney
  • This headache is different from your usual migraine attacks

The use of Migranal Nasal Spray should not exceed dosing guidelines and should not be used on a daily basis.

Serious cardiac (heart) events, including some that have been fatal, have occurred following use of injectable dihydroergotamine, the active ingredient in Migranal Nasal Spray, but are extremely rare.

You may experience some nasal congestion or irritation, altered sense of taste, sore throat, nausea, vomiting, dizziness, and fatigue after using Migranal Nasal Spray. Contact your doctor immediately if you experience:

  • Numbness or tingling in your fingers and toes
  • Pain, tightness, or discomfort in your chest
  • Muscle pain or cramps in your arms and legs
  • Weakness in your legs
  • Temporary speeding or slowing of your heart rate
  • Swelling or itching
Please click here for full Prescribing Information, including Boxed Warning and Patient Information.