D.H.E. 45® Injection for Migraine

Dihydroergotamine is an ergot-derived medicine for sudden migraine attacks. This page explains how the injection is used and stored, with practical safety notes. We provide US delivery from Canada, with options that help if you pay without insurance.

What D.H.E. 45 Is and How It Works

D.H.E. 45® contains dihydroergotamine mesylate, a vasoconstrictor used at the first signs of a migraine attack. It acts on serotonin and other receptors in cranial blood vessels, which can reduce inflammation and pain signaling during an attack. Migraine attacks vary, so your prescriber will decide when and how to use this option for acute episodes.

YouDrugstore is a licensed Canadian pharmacy in Manitoba. Pharmacists review prescriptions before dispensing.

Dihydroergotamine (DHE) Injection has been used for decades in clinics and at home. It may be given under the skin, into muscle, or intravenously under medical supervision. Many people receive an anti-nausea medicine with it to help tolerability.

Who It’s For

This treatment is for the acute management of migraine attacks with or without aura. Some clinicians also use it for difficult migraine patterns when other options are not suitable. DHE injection for migraine is not for prevention and is not taken daily.

Do not use if you have coronary artery disease, uncontrolled hypertension, peripheral vascular disease, severe liver or kidney impairment, sepsis, or known hypersensitivity to ergot alkaloids. It is contraindicated in pregnancy and while nursing. It must not be used with strong CYP3A4 inhibitors due to the risk of serious vasospasm and ischemia.

Dosage and Usage

Typical adult dosing starts at 1 mg for an attack, given subcutaneously or intramuscularly. A second 1 mg dose may be used as directed if symptoms persist. Intravenous dosing is done in a clinic, often with an antiemetic. Do not exceed the label’s daily and weekly limits set by your prescriber. Dihydroergotamine IV/IM injection schedules may vary based on clinical guidance and setting.

Use the injection at the earliest signs of a migraine for best effect. Rotate injection sites if using subcutaneous doses. Many prescribers recommend taking an anti-nausea medicine before dosing. For general self-injection steps, see our guide on technique in How To Inject Mounjaro and follow your clinician’s instructions for this medicine.

Strengths and Forms

Dihydroergotamine injection 1 mg/mL is typically supplied in single-use ampules or vials. Brands and generics may differ in packaging and carton sizes. Availability can vary by manufacturer and market.

Ask your prescriber if single-use ampules or flip-top vials are preferred for your plan. Your pharmacy team can help interpret the label and packaging.

Missed Dose and Timing

As an acute therapy, doses are taken for attacks, not on a fixed schedule. If an opportunity to inject passes, wait for the next episode as advised. With generic dihydroergotamine injection, do not double dose or exceed maximum daily or weekly limits.

Avoid dosing within 24 hours of triptans or other ergot medicines. If attacks are frequent, discuss preventive strategies with your prescriber.

Storage and Travel Basics

Keep dihydroergotamine injection vials in the original carton to protect from light. Store at room temperature per the product label and avoid excessive heat or freezing. Do not use if the solution changes color, contains particles, or an ampule cracks.

For travel, pack doses in your carry-on with your prescription label. Use a hard-sided container for sharps. Bring a note from your prescriber if needed for security. Keep medicines away from children and pets.

Pen Handling and Sharps Disposal

This product is supplied as vials or ampules, not a pen. Use sterile syringes and needles as instructed. Never reuse needles. Place used sharps in an approved sharps container. When full, follow local rules for disposal through a pharmacy or community program.

Benefits

This class can help when attacks are severe or when other acute options are not suitable. Injections may work when oral medicines are limited by nausea or vomiting. Clinic-based intravenous dosing provides supervised care for difficult episodes.

Multiple routes of administration give flexibility. Some patients prefer at-home subcutaneous dosing after training.

Side Effects and Safety

• Nausea or vomiting
• Dizziness or fatigue
• Flushing or increased sweating
• Tingling, numbness, or muscle cramps
• Injection site discomfort

Serious effects can include chest pain, shortness of breath, severe hypertension, cold or painful limbs, or symptoms of reduced blood flow. Rarely, prolonged vasospasm or ergotism can occur, especially with interacting medicines. Stop treatment and seek urgent care for concerning symptoms.

The label for D.H.E. 45 injection 1 mg/mL includes strict limits to reduce risks. Using this therapy too often may lead to medication-overuse headache. Your prescriber will help set a plan that fits your history.

Drug Interactions and Cautions

Do not use with strong CYP3A4 inhibitors such as certain azole antifungals, macrolide antibiotics, or HIV protease inhibitors. Combining with triptans or other ergot alkaloids within 24 hours is contraindicated. Avoid nicotine during treatment due to added vasoconstriction.

Use caution with cardiovascular disease risk factors. Tell your prescriber about all medicines, vitamins, and herbal supplements you take. This medicine is not for long-term daily use or prevention.

What to Expect Over Time

During an attack, relief may begin after dosing, though individual responses vary. Some patients need a second dose as directed. If nausea is expected, an antiemetic may improve comfort.

If migraines become more frequent, your clinician may adjust your broader plan. Educational resources like Migraine Headaches and Migraine Awareness Month can help you prepare questions for visits.

Compare With Alternatives

Other acute options include triptans and anti-inflammatory medicines. For a non-oral route, consider Imitrex Nasal Spray if a prescriber recommends a triptan. For an orally disintegrating choice, Zomig Rapimelt may be suitable when swallowing tablets is difficult. Each option has specific contraindications and interaction profiles.

Pricing and Access

We show current availability alongside transparent options for self-pay orders. Check the product page for your prescriber’s requirements and pharmacy processing details. For savings opportunities, see our Promotions page. Enjoy reassurance with Canadian pricing and US shipping from Canada.

Insurance coverage varies. If you are comparing therapies, your prescriber and insurer can advise on medical necessity and reimbursement pathways. Our team can help with invoice documentation for health spending accounts.

Availability and Substitutions

Supply can vary by manufacturer and format. If an item is temporarily unavailable, a prescriber may suggest an alternative acute therapy suitable for your history. Pharmacy teams can discuss packaging differences and answer questions about labeling.

Patient Suitability and Cost-Saving Tips

This option may suit adults with severe acute attacks, including those who cannot keep oral medicines down. It is not appropriate if you have significant cardiovascular disease, are pregnant, or use contraindicated interacting medicines. Teen or pediatric use requires specialist guidance.

To manage costs, consider multi-month quantities if your prescriber agrees and storage space allows. Use refill reminders so you keep a small reserve for travel. Ask about generic supply and pack sizes that reduce per-mL costs.

Questions to Ask Your Clinician

• When should I take the first dose during an attack?
• Do I need an anti-nausea medicine with each injection?
• What is my maximum allowed daily and weekly amount?
• Are triptans or NSAIDs reasonable alternatives for certain attacks?
• Which interacting medicines or supplements should I avoid?
• How should I adjust my plan if attacks cluster together?

Authoritative Sources

DailyMed: Dihydroergotamine Mesylate Injection

Health Canada Drug Product Database

Manufacturer Label Information

Order from YouDrugstore for express US delivery from Canada. This page is educational and does not replace guidance from your healthcare professional.