Orally inhaled dihydroergotamine: A novel ergot delivery method for the treatment of migraine

Orally inhaled dihydroergotamine (DHE) is a newly developed formulation of DHE for the treatment of acute migraine attack and is undergoing FDA review. This new agent provides an alternative to nonsteroidal anti-inflammatory drugs and triptans. In clinical trials, orally inhaled DHE was effective compared with placebo in relieving headache, nausea, phonophobia, and photophobia. No serious adverse events were documented; mild adverse effects included poor taste, nausea, coughing, and vomiting. Orally inhaled DHE has not yet been approved for use, so final dosing and cost information is not available. No head-to-head trials have been conducted to compare orally inhaled DHE with other medications to treat acute migraine attacks, so further studies may be necessary to determine comparative efficacy. Orally inhaled ORE may provide an effective option for patients with moderate to severe acute migraine attack. (Formulary. 2012;47:xxx-xxx)