Methysergide: Difference between revisions
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==FDA Package Insert== | ==FDA Package Insert== | ||
====Sansert (methysergide maleate) Tablet, Coated==== | |||
''' [[Methysergide indications and usage|Indications and Usage]]''' | ''' [[Methysergide indications and usage|Indications and Usage]]''' |
Revision as of 20:00, 7 February 2014
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AHFS/Drugs.com | Micromedex Detailed Consumer Information |
MedlinePlus | a603022 |
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E number | {{#property:P628}} |
ECHA InfoCard | {{#property:P2566}}Lua error in Module:EditAtWikidata at line 36: attempt to index field 'wikibase' (a nil value). |
Chemical and physical data | |
Formula | C21H27N3O2 |
Molar mass | 353.458 g/mol |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms / Brand Names: Sansert®
Overview
Methysergide (1-methyl-D-lysergic acid butanolamide or UML-491) is a prescription drug formerly used for prophylaxis of cluster headaches/migraine headaches, but is no longer recommended due to retroperitoneal/retropulmonary fibrosis. It was sold under the brand names Sansert and Deseril in 2 mg dosages.
Category
Antimigraine Drugs
FDA Package Insert
Sansert (methysergide maleate) Tablet, Coated
Indications and Usage | Dosage and Administration | Contraindications | Warnings and Precautions | Adverse Reactions | Drug Interactions | Use in Specific Populations | Overdosage | Description | Clinical Pharmacology | Nonclinical Toxicology | How Supplied/Storage and Handling | Patient Counseling Information
Medical uses
Methysergide is used to treat headaches such as migraine and other recurrent throbbing headaches.[1] Methysergide is one of the most effective[2] medications for the prevention of migraine, but not for the treatment of an acute attack.
It is also used in carcinoid syndrome to treat severe diarrhea.[1] It may also be used in the treatment of serotonin syndrome.[3]
Side effects
It has a known side effect, retroperitoneal fibrosis,[4] which is severe, although uncommon. Other severe but uncommon side effects include pleural fibrosis, and subendocardial fibrosis.
In addition, there is an increased risk of left-sided cardiac valve dysfunction.[2][5]
Mechanism of Action
Methysergide interacts with serotonin (5-HT) receptors. Its therapeutic effect in migraine prophylaxis has been associated with its antagonism at the 5-HT2B receptor.[6]
Furthermore, it is an antagonist at the 5-HT2C receptor, while at the 5-HT1A receptor it serves as a partial agonist.[7][8][9] It is known to have partial agonisteffects on some of the other 5-HT receptors as well.[10] Methysergide is metabolised intomethylergometrine in humans, which is responsible for its psychedelic effects.[11]
Historical Perspective
Methysergide was approved by the U.S. Food and Drug Administration (FDA) in 1962.
Novartis withdrew it from the U.S. market after taking over Sandoz, but currently lists it as a product.
See also
References
- ↑ 1.0 1.1 http://www.patient.co.uk/medicine/Methysergide.htm
- ↑ 2.0 2.1 Joseph T, Tam SK, Kamat BR, Mangion JR (2003). "Successful repair of aortic and mitral incompetence induced by methylsergide maleate: confirmation by intraoperative transesophageal echocardiography". Echocardiography. 20 (3): 283–7. doi:10.1046/j.1540-8175.2003.03027.x. PMID 12848667.
- ↑ Sporer, KA (1995). "The Serotonin Syndrome Implicated Drugs, Pathophysiology and Management". Drug Safety. 13 (2): 94–104. doi:10.2165/00002018-199513020-00004. PMID 7576268.
- ↑ emedicine.com (2002)
- ↑ 1997 Mayo Clinic study linking heart disease to Fen Phen Valvular heart disease associated with fenfluramine-phentermine
- ↑ Schmuck K, Ullmer C, Kalkman HO, Probst A, Lubbert H (May 1996). "Activation of meningeal 5-HT2B receptors: an early step in the generation of migraine headache?". Eur. J. Neurosci. 8 (5): 959–67. doi:10.1111/j.1460-9568.1996.tb01583.x. PMID 8743744.
- ↑ Rang, H. P. (2003). Pharmacology. Edinburgh: Churchill Livingstone. ISBN 0-443-07145-4. Page 187
- ↑ Saxena PR, Lawang A (October 1985). "A comparison of cardiovascular and smooth muscle effects of 5-hydroxytryptamine and 5-carboxamidotryptamine, a selective agonist of 5-HT1 receptors". Arch Int Pharmacodyn Ther. 277 (2): 235–52. PMID 2933009.
- ↑ http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=9681
- ↑ Colpaert FC, Niemegeers CJ, Janssen PA (October 1979). "In vivo evidence of partial agonist activity exerted by purported 5-hydroxytryptamine antagonists". Eur. J. Pharmacol. 58 (4): 505–9. doi:10.1016/0014-2999(79)90326-1. PMID 510385.
- ↑ Bredberg, U. (1 January 1986). "Pharmacokinetics of methysergide and its metabolite methylergometrine in man". European Journal of Clinical Pharmacology. 30 (1): 75–77. doi:10.1007/BF00614199. PMID 3709634. Unknown parameter
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External links
- Novartis Sansert site.
- Novartis Sansert product description.
- Migraines.org More detailed information on methysergide.
- neurologychannel.com, general information on migraines.
- History of methysergide in migraine.
- Pages with script errors
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- Antimigraine drugs
- Lysergamides