Orally inhaled dihydroergotamine: a review.

摘要: Orally inhalable dihydroergotamine (iDHE), before the US Food and Drug Administration in 2013 for consideration approval acute treatment of episodic migraine adults, is a user-friendly formulation an older medication. Dihydroergotamine (DHE) has heterogeneous receptor profile, central penetration, persistent binding that may account its clinical prolonged benefits migraine. The same features result ability DHE to reverse sensitization allodynia maintain efficacy deep into attacks. These characteristics make particularly useful treating upon awakening, status migrainosus, menstrually related migraine, bridging patients out medication-overuse headache/chronic helpful pharmacokinetics, with lower maximal serum concentration than intravenous which minimal nausea, less potentially toxic serotonin2B receptor. inhaler itself designed delivery reproducible aliquots intrapulmonary only nominal need patient coordination. form allows bypassing gastrointestinal tract setting nausea or vomiting, greatly reduces first-pass effect. No drug-related serious adverse events were reported during Phase 3 study iDHE. Product taste most common side effects both regulatory trial safety extension trial. Limitations use iDHE are those any ergot triptan, ie, contraindication vascular disease. In addition, metabolized by cytochrome P450 3A4 liver enzymatic system. Inhalable provides promise new valued medication important features, attacks variety situations.