One Response to “Methergine – Any info?”

1. admin says:

   November 23, 2009 at 12:43 am

   In article <2vcfjq$…@apple.com>, Rebecca Hammaker <hamma…@apple.com> wrote:
   >I was recently prescribed a medication called
   >Methergine to take along with Verelan for prevention
   >of Migraine headache. I have so far been unable to
   >find any information at all on Methergine (except
   >what my doctor told me). I understand it is an
   >ergotamine derivative? Does anyone have any information
   >at all on this drug? Specifically I’m looking at
   >possible long term effects, but would appreciate
   >any information anyone would be willing to share.

   Methergine is a tradename for methylergovovine, which is usually
   classified as an oxytocic agent (i.e., an agent formerly used to
   induce labor and currently to halt post-partum uterine bleeding.)
   It’s an ergot derivative, but whereas ergotamine has a cyclic peptide
   hanging off of the lysergic acid moiety, methylergonovine is a simple
   lysergic acid amide.

   I know that this and a related drug ergonovine do seem to have some
   use by neurologists in the treatment of migraine, though I must confess
   I’m not really up on its use for this indication (such use is off-label–
   the FDA approved labelling simply talks about methylergonovine
   as an oxytocic.  This isn’t necessarily worrisome, since a drug’s
   clinical use almost always outpaces its FDA approved labelling.)

   However, one drug which _is_ used as migraine prophylaxis is
   methysergide (Sansert), and that’s simply methylergonovine with an
   extra methyl group on the indole nitrogen.  Recent research has
   suggested that methysergide is actually a pro-drug which is rapidly
   converted to methylergovovine once ingested.  This might suggest that
   methylergonovine could itself be useful as a prophylactic agent.
   Long-term uninterrupted use of methysergide can cause fibrosis;
   therefore, it would not be unreasonable to assume that similar
   chronic use of methylergonovine might have a potential for this
   side effect, at least in the absence of wider experience with
   using the drug for this indication.  I’m talking _completely_ off
   the top of my head here, which is why I’m adding sci.med to the
   newsgroups distribution list, where neurologists like Dr. Nye
   can see it and potentially offer a few more informed comments.

   –
   Steve Dyer
   d…@ursa-major.spdcc.com