Description:

Cafergot Tablets (20 tablets by AMDIPHARM) is a combination medication used for the acute treatment and relief of migraine headaches with or without aura. It is not a preventive treatment. The product combines ergotamine (a vasoconstrictor that narrows blood vessels in the brain) with caffeine (which enhances ergotamine absorption and vasoconstriction). It is indicated for moderate to severe migraine attacks when other treatments (e.g., triptans) are ineffective, not tolerated, or contraindicated. In Ghana (Accra), it remains available in pharmacies as a prescription medication for acute migraine management, though its use has declined due to newer and safer alternatives.

Prescription:

Prescription-only (requires a doctor’s prescription in Ghana; dispensed by pharmacies with Rx; typically prescribed by neurologists, general practitioners, or physicians familiar with migraine management; not OTC due to risk of medication-overuse headache, ergotism, and cardiovascular complications).

Therapeutic Category:

Ergot Alkaloid + Stimulant / Acute Migraine Treatment (Vasoconstrictor combination for abortive migraine therapy Ergotamine combinations).

Active Ingredients/Composition: Each tablet contains:

• Ergotamine tartrate – 1 mg
• Caffeine – 100 mg Other ingredients (excipients, typical): Lactose monohydrate, microcrystalline cellulose, maize starch, povidone, magnesium stearate, talc, and film-coating agents (hypromellose, titanium dioxide, macrogol). Tablets are usually white or off-white, round, uncoated or film-coated, and may be scored.

Vitamins: None.

Minerals: None.

Variant:

• Cafergot 1 mg/100 mg tablets (standard strength; pack of 20 tablets). No major variants in tablet form; related products include Cafergot suppositories (for severe nausea/vomiting with migraine) or other ergotamine-containing preparations (now rare). The 20-tablet pack is the most common retail presentation.

Consume Type:

Oral – Tablet (swallow whole with water; best taken at the onset of migraine headache).

Directions/Usage:

• Adults: Take 1 tablet at the first sign of a migraine attack.
• If relief is incomplete after 30 minutes, take a second tablet.
• Maximum: 2 tablets per attack; do not exceed 4 tablets in any 24-hour period or 10 tablets in any week.
• Take as early as possible in the headache phase (most effective at onset).
• Do not use prophylactically (only for acute attacks).
• Avoid taking with food (may slow absorption); take with water.
• Duration: Use only for acute attacks; do not use more than 2–3 days per week to avoid medication-overuse headache.

Common Side Effects: Common:

• Nausea, vomiting (very frequent – often occurs with migraine itself).
• Dizziness, drowsiness.
• Abdominal pain, muscle cramps.
• Tingling or numbness in extremities.
• Weakness or fatigue. Rare/serious (seek immediate help): Severe chest pain, irregular heartbeat, severe leg cramps, cold/pale extremities (signs of ergotism/vasospasm), severe headache, confusion, seizures, or signs of serotonin syndrome (if combined with other serotonergic drugs).

Package Type:

Blister packs (usually 20 tablets; 2×10 or 4×5 foil blisters in carton with patient information leaflet and warnings about ergotism and overuse).

Storage Advice: Store at room temperature (below 25–30°C) in original packaging, protected from light and moisture. Keep tightly closed. Out of reach of children.

Safety Advice:

• High risk of serious complications – do not exceed recommended dose or frequency (risk of ergotism: severe vasospasm, gangrene, or ischemia).
• Contraindicated in:
  • Peripheral vascular disease, coronary artery disease, uncontrolled hypertension, severe liver/kidney impairment
  • Pregnancy and breastfeeding (teratogenic and toxic to infant)
  • Concomitant use with strong CYP3A4 inhibitors (e.g., erythromycin, ketoconazole, ritonavir – increases ergot toxicity)
  • History of medication-overuse headache
• Caution in elderly, smokers, or patients with Raynaud’s phenomenon.
• Do not use daily or for prevention – increases risk of rebound/medication-overuse headache.
• Report immediately: severe chest pain, leg pain/cramps, numbness, cold extremities, confusion, or persistent headache.
• Keep out of reach of children (overdose risk – can be fatal).

Product Substitutes: Similar ergotamine + caffeine tablets in Ghana (now less common):

• Generic ergotamine tartrate 1 mg + caffeine 100 mg tablets (various importers).
• Cafergot (original brand by Novartis or generics). Modern preferred alternatives (safer profile):
• Sumatriptan, rizatriptan, zolmitriptan, eletriptan (triptans)
• NSAIDs (ibuprofen, naproxen) + antiemetics
• Acetaminophen or aspirin combinations
• For acute migraine: Ubrelvy (ubrogepant) or Nurtec (rimegepant) – if available. Consult neurologist or physician in Accra for safer modern migraine treatments.

Manufacturer/Marketer:

AMDIPHARM (a European pharmaceutical company specializing in niche and older medicines; markets Cafergot and similar products under license). Marketed/distributed in Ghana by local importers/pharmacies (available but declining in use).

Country of Origin:

Varies by batch/market (original Cafergot formulations manufactured in Europe – e.g., Switzerland, Ireland, or Netherlands; generics from India commonly imported to Ghana).