What is Dihydroergotamine (DHE)?

Dyhydroergotamine (DHE) is a medication from the ergotamine family that acts on some of the same receptors that triptan medications act on (i.e. Imitrex (sumatriptan)), but it is a distinct medication.  DHE is generally well tolerated and very helpful to many patients with frequent headache. The goal of inpatient DHE treatment is that it will help to start to improve a chronic headache disorder. It is viewed as part of a comprehensive treatment plan for chronic headache, and do not anticipate that it will necessarily “break” the headache by itself.

DHE has been used for headache for over 50 years.  Inpatient treatment with IV DHE is an established practice used in many medical centers for both episodic and chronic headache disorders.

Due to potential adverse medication interactions, triptan medications should not be given within 24 to 48 hours (before and after) of DHE administration.

What to expect during your stay

The most common side effect is nausea, and we take steps to try to prevent or reduce the symptom by giving an anti-nausea medication prior to each dose of DHE.  There are also other measures we can take to help with nausea so it is important to tell the staff how well your nausea is being controlled.

Other potential side effects include leg cramping, stomach cramping, and diarrhea. Occasionally, it becomes difficult to keep IV sites working, so they may need to be replaced.

In a small number of patients, their headaches may become briefly and slightly worsened, typically after the first few doses of DHE. When this occurs, it is not an indication of effectiveness. If this occurs, and is intolerable, often slowing the administration of the dose will usually resolve this side effect.

What happens when my stay is over?

While IV DHE is not a cure for migraine, most patients will achieve the goal of a reduction in their headaches for weeks to months after discharge.

Many patients still have headache at the time of discharge.  It may take two weeks to a month following hospital stay before the maximum improvement occurs. Headache freedom at discharge is not predictive of the overall benefit from IV DHE.

Prior to discharge, you will discuss a headache care plan.   It is important to remain committed to the plan which is individualized to your specific situation. If after your discharge, you have questions or concerns with the treatment plan, please call our West Campus Neurology clinic nurses or send a MyChart message to your physician or nurse to discuss these issues.