Dihydroergotamine (DHE) Injection for Acute Migraine and Cluster Headache

What Dihydroergotamine (DHE) Injection Is and How It Works

Dihydroergotamine (DHE) Injection is an ergot alkaloid used for acute migraine and cluster headache attacks. It is given subcutaneously, intramuscularly, or intravenously, and is usually taken at the first sign of an attack. Many patients look for Dihydroergotamine injection without insurance, and YouDrugstore helps by offering Canadian pricing and convenient shipping to the US.

YouDrugstore is a licensed Canadian pharmacy headquartered in Manitoba and operating to Canadian pharmacy standards. A licensed pharmacist reviews each prescription before dispensing. You can order online and reach our friendly customer-service chat during posted office hours, and our pharmacists can address medication questions.

We also partner with vetted, licensed pharmacies worldwide to source authentic brands and a broad range of generics at fair prices.

Dihydroergotamine works by stimulating 5-HT_1B/1D receptors and other vascular receptors, which constrict dilated cranial blood vessels and inhibit inflammatory neuropeptide release. This multi-receptor action can help stop a migraine cascade and relieve cluster headache pain. It is not for prevention and should not be used for chronic daily dosing.

Dosage and Usage

Use DHE exactly as directed by the prescriber. Typical adult dosing for acute migraine or cluster headache:

• At attack onset: 0.5 mg to 1 mg by subcutaneous or intramuscular injection.
• If needed, you may repeat after one hour.
• Do not exceed 3 mg in 24 hours or 6 mg in one week.
• Some patients receive IV dosing in clinic as a structured protocol. Home IV use should follow a specialist plan.
• An antiemetic (for example, metoclopramide) is often taken with DHE to reduce nausea.

Missed dose guidance:

• DHE is taken as needed at attack onset. If you did not use it during an attack, wait for the next attack to start dosing.
• Do not “catch up” by exceeding the daily or weekly limits.

Storage and travel tips:

• Store vials or ampoules at 20–25°C (68–77°F) and protect from light in the original carton.
• Do not freeze. Do not use if the solution is discolored or contains particles.
• When traveling, keep your supply in your carry-on, with prescription labels visible.
• A small insulated pouch helps avoid temperature extremes during summer or winter travel.

Benefits and Savings

DHE offers broad relief for migraine and cluster headache by acting at multiple receptors implicated in the pain pathway. It can help when triptans are not tolerated or have failed. Many patients value the flexible routes of administration, including self-injection at home after proper training.

Ordering through YouDrugstore can provide 60–80% savings compared with typical US prices. These savings can be meaningful for those paying without insurance. Our team supports you with clear updates and careful dispensing, and we carry both brand and generic options when available.

Side Effects and Safety

Common side effects:

• Nausea or vomiting (often reduced with an antiemetic)
• Flushing, warmth, or sweating
• Dizziness or fatigue
• Injection-site pain or tenderness
• Altered taste or nasal symptoms if using a nasal formulation on other days

Serious effects that need urgent medical attention:

• Chest pain, shortness of breath, or rapid heartbeat
• Severe or worsening headache different from usual attacks
• Cold, pale, numb, or painful fingers or toes (signs of ischemia)
• Sudden weakness, trouble speaking, or vision changes
• Severe abdominal pain

Key contraindications and cautions:

• Coronary artery disease, peripheral vascular disease, uncontrolled hypertension, or stroke/TIA history
• Pregnancy or plans to become pregnant; DHE is contraindicated and may cause uterine contractions
• Breastfeeding (drug passes into breast milk)
• Severe liver or kidney impairment, sepsis, or recent surgery
• Basilar or hemiplegic migraine

Drug interactions to avoid:

• Any triptan within 24 hours of DHE (and vice versa)
• Other ergot medicines
• Strong CYP3A4 inhibitors (for example, ritonavir, nirmatrelvir/ritonavir, clarithromycin, erythromycin, ketoconazole, itraconazole), due to risk of serious ischemia
• Some antidepressants and serotonergic agents may raise serotonin syndrome risk; clinical judgment is required

Do not overuse DHE. Too-frequent use may lead to medication-overuse headache or ergotism. Keep a headache diary and share it with the prescriber.

Onset Time

Relief often starts within 30 to 60 minutes after injection, with further improvement over 2 hours. Cluster headache pain may subside quickly when DHE is given early. Individual results vary by attack stage, dose, and route.

Compare With Alternatives

Triptans are first-line for many attacks. Sumatriptan is available in several forms. Patients who prefer tablets may consider Imitrex® DF, while nasal options include Zomig® Nasal Spray and Imitrex® Nasal Spray. Triptans act at 5‑HT_1B/1D receptors but may be less effective or contraindicated in some patients.

Nasal dihydroergotamine (brand Migranal) offers a non-injectable route, though onset can be slower than injection and dosage differs. Newer acute options include gepants (ubrogepant, rimegepant) for patients who cannot use vasoconstrictors. Choice depends on medical history, attack pattern, and prior response.

Combination Therapy

DHE is often combined with an antiemetic such as metoclopramide or prochlorperazine to reduce nausea and improve tolerability. Some patients add NSAIDs or acetaminophen if approved by their prescriber. In clinic, DHE can be part of a structured infusion protocol that includes hydration and antiemetics.

Preventive treatments can lower attack frequency and improve the effectiveness of acute therapy. Options include beta blockers, topiramate, verapamil (especially in cluster headache), onabotulinumtoxinA for chronic migraine, and CGRP monoclonal antibodies. The prescriber personalizes plans based on diagnosis and comorbidities.

Patient Suitability and Cost-Saving Tips

DHE may suit patients who need a non-oral option, who wake with severe attacks, or who have delayed gastric emptying. It can help when triptans are ineffective or poorly tolerated. It is not appropriate for people with cardiovascular disease, severe hypertension, pregnancy, or those taking strong CYP3A4 inhibitors.

To manage costs, consider multi-month supplies when appropriate. Per-month pricing often decreases with larger fills, and our team can send friendly reorder reminders so you do not run out. For current deals, see our DHE injection coupon page for promotions and bulk options.

If DHE aligns with your diagnosis, you can complete checkout online. You can also reach customer-service chat during posted hours for help with ordering or shipping. For condition education, review our category pages on Cluster Headache and Migraine. You can also read our articles, including National Migraine And Headache Awareness Month Breaking Barriers To Better Care and What Are Migraine Headaches Are They A Type Of Epilepsy, for broader insights. If you are paying without insurance, our Canadian pricing model helps reduce out-of-pocket costs.

Authoritative Sources

For full prescribing and safety details, consult these resources:

• FDA Prescribing Information for D.H.E. 45 (dihydroergotamine mesylate)
• Health Canada Drug Product Database: Dihydroergotamine entries
• Manufacturer information for D.H.E. 45 Injection

You can order DHE from YouDrugstore with confidence. We are a licensed Canadian pharmacy, and pharmacist-reviewed prescriptions are dispensed with care. We offer prompt, express, cold-chain shipping to the US, with clear updates at each step.

Content on this page is for educational purposes and does not replace medical advice. Always follow the prescriber’s guidance and the product insert. Brand names are used to identify products; all trademarks are the property of their respective owners.