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Ergotamine + caffeine is a fixed-dose combination drug used to treat or prevent vascular headaches, including migraine and cluster headaches. Ergotamine is an ergot alkaloid that acts as an alpha-adrenergic blocker with direct stimulatory effects on the smooth muscle of peripheral and cranial blood vessels, leading to vasoconstriction. It also exhibits serotonin antagonism. Caffeine enhances the vasoconstrictive effect of ergotamine and increases its absorption without requiring higher doses of ergotamine itself. The combination works by narrowing dilated blood vessels in the head that are believed to cause headache pain[1][3][4][5][6]. This medication is available as oral tablets (typically 1 mg ergotamine/100 mg caffeine per tablet) or rectal suppositories (2 mg ergotamine/100 mg caffeine per suppository)[7][8]. Brand name Cafergot has been discontinued in many markets but generic versions remain available[1][7].
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