Understanding Migraines

Who is affected?

If you are suffering from migraines, you are not alone. Migraine is the 3rd most common illness in the world and affects 39 million Americans.1

The 4 Stages of Migraine

Everyone experiences migraines differently. Migraines typically move through 4 stages, and you may or may not go through each stage.2

MIGRANAL is proven to provide relief during a migraine attack for patients who suffer from migraines with or without aura.3*

*MIGRANAL should not be used to prevent a migraine from happening.

Mygraine Triggers

It can be hard to figure out what is causing your migraines, but there are common triggers for many people who get migraines, including4:


Chocolate, dairy products, foods containing MSG, foods with tyramine (eg, red wine, smoked fish, figs), some fruits, nitrates (eg, hot dogs, bacon, cured meats), nuts and seeds, and processed/fermented/pickled or marinated foods


Loud noises, bright lights, certain odors or perfumes, and cigarette smoke


Caffeine withdrawal, sleep disturbances, exercise, skipping meals, and stress/anxiety


Hormone changes in women due to menstrual cycles and/or birth control pills

MIGRANAL: Because Mygraine Is Different

Do any of the following apply to you?

Wake up with migraines3,5,6
Unable to take an oral migraine medicine due to nausea or vomiting3,5,6
Delay using your migraine medicine until the pain is severe3,5-7
Find your current migraine medicine isn’t working well3,5-7

If you answered “yes” to any of the above, MIGRANAL may be the right migraine medicine for you.

  1. Migraine Research Foundation. Migraine facts. http://migraineresearchfoundation.org/about-migraine/migraine-facts/. Accessed October 1, 2019.
  2. Mayo Clinic. Migraine. https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201. Accessed October 1, 2019.
  3. MIGRANAL [package insert]. Bridgewater, NJ: Bausch Health Companies Inc.
  4. National Institutes of Health. MedlinePlus. Migraine. https://medlineplus.gov/ency/article/000709.htm. Accessed October 1, 2019.
  5. Gallagher RM; Dihydroergotamine Working Group. Acute treatment of migraine with dihydroergotamine nasal spray. Arch Neurol. 1996;53(12):1285-1291.
  6. Baron EP, Tepper SJ. Revisiting the role of ergots in the treatment of migraine and headache. Headache. 2010;50(8):1353-1361.
  7. Silberstein S. 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.

MIGRANAL® (dihydroergotamine mesylate) 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.


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

You are encouraged to report adverse side effects of prescription drugs to Bausch Health US, LLC at 1-800-321-4576 or the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please click here for full Prescribing Information, including Boxed Warning and Patient Information.