Methysergide

Methysergide Brand Name– Sansert

What is Methysergide

NOTE: This drug is discontinued in the US.

Methysergide is an oral, synthetic ergot alkaloid, structurally related to the oxytocic agent methylergonovine and to the potent hallucinogen LSD.

Methysergide is used prophylactically to reduce the frequency and intensity of severe vascular headaches. Although methysergide is an ergot alkaloid, it is a weak vasoconstrictor.

Methysergide is a more potent antagonist of peripheral serotonin receptors than other ergot alkaloids.

Although methysergide and sumatriptan both stimulate serotonin receptors centrally, methysergide is intended for prophylaxis while sumatriptan is indicated for treatment of an acute attack.

Prolonged use or excessive dosage of ergot alkaloids can lead to ergotism, dependence, and/or rebound headaches.

Methysergide should be prescribed in strict accordance with manufacturer guidelines; dosage limits should not be exceeded.

Methysergide was approved by the FDA in 1962.

The Sansert® product is discontinued as of November 19, 2002 but remaining supplies that expire in February 2003 may be ordered by calling Novartis at (888) 669—6682 until the supplies are exhausted or have expired.

Indications

  • carcinoid
  • migraine prophylaxis
  • narcolepsy

For the prevention, or reduction of intensity and frequency, of vascular headache (e.g., migraine prophylaxis, cluster headache prophylaxis) in patients suffering one or more severe vascular headaches per week; including those that are uncontrollable or so severe that prophylaxis is indicated regardless of frequency

Side Effects

  1. abdominal pain
  2. alopecia
  3. angina
  4. arthralgia
  5. asthenia
  6. ataxia
  7. blurred vision
  8. cardiac valvulopathy
  9. chest pain (unspecified)
  10. confusion
  11. constipation
  12. coronary vasospasm
  13. diarrhea
  14. drowsiness
  15. dyspepsia
  16. dyspnea
  17. eosinophilia
  18. euphoria
  19. fetal death
  20. flushing
  21. hallucinations
  22. hyperesthesia
  23. hypertension
  24. insomnia
  25. myalgia
  26. mydriasis
  27. myocardial infarction
  28. nausea
  29. neutropenia
  30. orthostatic hypotension
  31. paresthesias
  32. peripheral edema
  33. peripheral vasoconstriction
  34. phlebitis
  35. pruritus
  36. pulmonary fibrosis
  37. pyrosis (heartburn)
  38. retroperitoneal fibrosis
  39. seizures
  40. sinus tachycardia
  41. spontaneous fetal abortion
  42. telangiectasia
  43. teratogenesis
  44. thrombocytopenia
  45. tissue necrosis
  46. uterine contractions
  47. vomiting
  48. weakness
  49. weight gain

Monitoring Parameters

  • pulmonary function tests (PFTs)

Contraindications

  • abrupt discontinuation
  • angina
  • arteriosclerosis
  • basilar/hemiplegic migraine
  • biliary tract disease
  • breast-feeding
  • cardiac disease
  • children
  • cholestasis
  • coronary artery disease
  • diabetes mellitus
  • eclampsia
  • ergot alkaloid hypersensitivity
  • geriatric
  • hepatic disease
  • hypercholesterolemia
  • hypertension
  • infants
  • labor
  • myocardial infarction
  • neonates
  • obesity
  • obstetric delivery
  • peptic ulcer disease
  • peripheral vascular disease
  • preeclampsia
  • pregnancy
  • pulmonary disease
  • pulmonary fibrosis
  • Raynaud’s phenomenon
  • renal disease
  • renal failure
  • renal impairment
  • retroperitoneal fibrosis
  • rheumatoid arthritis
  • sepsis
  • stroke
  • surgery
  • systemic lupus erythematosus (SLE)
  • tartrazine dye hypersensitivity
  • thromboangiitis obliterans (Buerger’s disease)
  • thrombophlebitis
  • tobacco smoking
  • valvular heart disease

Interactions

  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Pseudoephedrine
  • Acrivastine; Pseudoephedrine
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Almotriptan
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine; Dextroamphetamine Salts
  • Aprepitant, Fosaprepitant
  • Articaine; Epinephrine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzphetamine
  • Beta-blockers
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Boceprevir
  • Bromocriptine
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Cabergoline
  • Calcium-channel blockers
  • Carbetapentane; Pseudoephedrine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Pseudoephedrine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chloroprocaine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Pseudoephedrine
  • Cimetidine
  • Citalopram
  • Clarithromycin
  • Clevidipine
  • Cocaine
  • Danazol
  • Delavirdine
  • Desloratadine; Pseudoephedrine
  • Desvenlafaxine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Dobutamine
  • Duloxetine
  • Elbasvir; Grazoprevir
  • Eletriptan
  • Enalapril; Felodipine
  • Epinephrine
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Felodipine
  • Fexofenadine; Pseudoephedrine
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluvoxamine
  • Frovatriptan
  • grapefruit juice
  • Green Tea
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Pseudoephedrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen; Pseudoephedrine
  • Imatinib
  • Isoproterenol
  • Isradipine
  • Itraconazole
  • Ketoconazole
  • Letermovir
  • Levomilnacipran
  • Lidocaine; Prilocaine
  • Linezolid
  • Lisdexamfetamine
  • Loratadine; Pseudoephedrine
  • Lorcaserin
  • Mepivacaine
  • Mepivacaine; Levonordefrin
  • Methamphetamine
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methylene Blue
  • Metronidazole
  • Miconazole
  • Milnacipran
  • Mirtazapine
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Naratriptan
  • Nefazodone
  • Nicardipine
  • Nicotine
  • Nifedipine
  • Nilotinib
  • Nimodipine
  • Nisoldipine
  • Nitrates
  • Nitroprusside
  • Paroxetine
  • Perindopril; Amlodipine
  • Phentermine
  • Phentermine; Topiramate
  • Posaconazole
  • Prilocaine
  • Prilocaine; Epinephrine
  • Procaine
  • Protease inhibitors
  • Pseudoephedrine
  • Quinine
  • Ranolazine
  • Rizatriptan
  • Rufinamide
  • Serotonin norepinephrine reuptake inhibitors
  • Serotonin-Receptor Agonists
  • Sertraline
  • Sibutramine
  • Sumatriptan
  • Tedizolid
  • Telaprevir
  • Telithromycin
  • tobacco
  • Trandolapril; Verapamil
  • Vasopressors
  • Venlafaxine
  • Verapamil
  • Vilazodone
  • Voriconazole
  • Vortioxetine
  • Zafirlukast
  • Zileuton
  • Zolmitriptan