D.H.E. 45® Injection for Migraine

Dihydroergotamine is a prescription ergot derivative used for sudden migraine attacks and some cluster headaches. It can be given under the skin, into a muscle, or by IV in a clinic. This page explains uses, safety, and access so you can make an informed choice.

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

Dihydroergotamine (DHE) Injection is an acute migraine therapy that narrows dilated cranial blood vessels and modulates trigeminal pathways believed to drive headache pain. It is not a daily preventive medicine. Many patients explore this option for its established role in difficult or refractory attacks. We offer US delivery from Canada to expand access and potential savings without insurance. Border Free Health connects U.S. patients with licensed Canadian partner pharmacies; prescriptions are verified with prescribers before dispensing.

This medicine is an ergot alkaloid that acts on serotonin, adrenergic, and dopaminergic receptors. The combined actions may reduce neurogenic inflammation and limit vasodilation. D.H.E. 45® is the best-known brand; generics are widely used where available.

Who It’s For

The treatment is indicated for the acute treatment of migraine with or without aura. It may also be used for acute cluster headache in appropriate adults under a prescriber’s care. It is not for prevention. Avoid use if you have ischemic heart disease, coronary vasospasm, uncontrolled hypertension, peripheral vascular disease, severe liver or kidney impairment, sepsis, or are pregnant. Do not use during breastfeeding unless your clinician advises otherwise. An evaluation for cardiovascular risk is recommended before first use in patients with risk factors.

DHE injection for migraine can be suitable when triptans are ineffective, not tolerated, or contraindicated. People with basilar or hemiplegic migraine require specific clinical guidance. Always follow your prescriber’s directions.

Dosage and Usage

Prescribers may administer the first dose in a clinic to monitor response. Typical routes include subcutaneous or intramuscular injection at the first sign of a headache. Additional doses may be given after an interval if the attack persists, with strict daily and weekly maximums set in the official label. If you also use anti-nausea medicine, your clinician may advise taking it before the injection to limit queasiness.

DHE injection dosing 1 mg/mL is common in practice. Do not exceed the label’s total daily limit or the weekly limit. Do not use this medicine within 24 hours of any triptan. If you have had recent ergot use, wait as directed by your prescriber before taking another ergot-containing product. For clinic IV therapy, nurses typically monitor blood pressure and symptoms during and after the infusion.

Administration basics:

• Choose approved injection sites and rotate locations.
• Clean the skin with an alcohol swab before injection.
• Use a new sterile syringe and needle for each dose.
• Follow your clinician’s spacing between doses within an attack.
• Stop treatment and seek care if you develop chest pain, severe numbness, or pallor in fingers or toes.

Strengths and Forms

The product is supplied as a solution in vials or ampules for subcutaneous, intramuscular, or intravenous use. Availability can vary by supplier.

Commonly published presentations include:

• dihydroergotamine mesylate injection 1 mg/mL single-dose vials or ampules

Some packs include multiple single-use units. Follow your pharmacy label for the supplied presentation.

Missed Dose and Timing

This therapy is used at headache onset, not on a fixed schedule. If you planned a dose for an attack and did not take it, use it when the next attack begins as directed. Do not take extra doses to make up for a missed opportunity. Respect the daily and weekly limits, and do not combine with triptans within the same 24-hour period.

Storage and Travel Basics

Store vials or ampules at room temperature as stated on the product label. Keep in the original carton to protect from light. Do not freeze. Keep out of reach of children. Discard any unit that is cracked, discolored, or contains particles. Once opened, single-dose units should not be saved for later use.

For travel, pack supplies in a secure case with your prescription label. Keep medicines in carry-on baggage when flying. If your route involves temperature extremes, ask your pharmacist about small insulated pouches. Documentation from your prescriber can help during security checks. Use a sharps container on the road when possible.

Pen Handling and Sharps Disposal

This product is supplied for syringe injection rather than a pen. Always dispose of used needles and syringes in an FDA-cleared sharps container. If you do not have one, use a heavy-duty plastic household container with a tight, puncture-resistant lid until you can obtain a proper sharps container. Follow local or state guidance for disposal. Never throw loose needles into household trash.

Benefits

As an established acute therapy, this medicine offers a non-triptan option that can be used across multiple routes. A clinician may use IV therapy in clinic for severe or refractory attacks, while at-home injections provide flexibility when a triptan is not suitable. It can be used with antiemetics for nausea management during attacks.

Many patients reach for generic dihydroergotamine injection when they need an option with a different mechanism than triptans. Discuss the most appropriate route and setting with your prescriber.

Side Effects and Safety

Common side effects can include:

• Nausea or vomiting
• Dizziness or flushing
• Injection site pain or tenderness
• Fatigue
• Altered taste

Serious reactions are uncommon but can include chest pain, severe hypertension, ischemia in the fingers or toes, shortness of breath, or allergic reactions. Stop use and seek emergency help if you notice signs of reduced blood flow, such as numbness, coldness, or bluish discoloration in extremities. Using this class with certain antibiotics, protease inhibitors, or azole antifungals can raise blood levels and increase risk. Risk of low blood sugar is not expected unless taken with unrelated agents that affect glucose. Always review the Medication Guide and full Prescribing Information.

Drug Interactions and Cautions

Do not use within 24 hours of any triptan. Avoid with other ergot medicines. Strong CYP3A4 inhibitors (for example, some macrolide antibiotics, protease inhibitors, and azole antifungals) are contraindicated due to serious ischemia risk. Discuss other serotonergic medications, nicotine use, and blood pressure medicines with your prescriber. Alcohol may worsen headache or dizziness. If you have risk factors for heart disease, a cardiovascular assessment is advisable before first use.

What to Expect Over Time

Relief typically depends on the route and timing. Some people respond to an early dose at onset; others may require a second dose, within label limits, during the same attack. A clinician may recommend IV administration for status migrainosus. If you need treatment frequently, your prescriber may reassess triggers or preventive options. Keep a headache diary to track timing, dose, and response, which helps guide ongoing care.

Compare With Alternatives

Many adults first try a triptan. If a triptan is not appropriate, or if response is incomplete, this therapy offers a different mechanism. Two prescription alternatives we carry include:

• Sumatriptan — a widely used triptan available in tablets, nasal spray, and injection.
• Nurtec® ODT — an oral CGRP antagonist used for acute treatment in adults.

Discuss with your clinician which option aligns with your history and risk factors.

Pricing and Access

We aim to make Canadian-sourced options straightforward for U.S. patients. You can review current availability and place an order with your prescription. Our encrypted checkout supports secure payment. Ask your prescriber to send the script to our partner pharmacy as directed.

Many shoppers look up dihydroergotamine injection price to compare options. We provide transparent product pages so you can check supply, pack sizes, and guidance on fulfilment. US delivery terms reflect cross-border handling. Orders Ships from Canada to US with clear tracking. Savings vary by plan and eligibility.

If you are searching for coupons, see our latest site offers on Promotions for general tips. Offers may change without notice.

Availability and Substitutions

Supply can vary by manufacturer. If a specific presentation is unavailable, a prescriber may recommend an alternative route or a different acute therapy. Do not switch to another ergot or a triptan without medical guidance. If needed, our team can coordinate with your clinician to review options.

Some patients ask how to order dihydroergotamine injection when their local stock is limited. You can upload your prescription and our partner pharmacy will fill it when verified by your prescriber.

Patient Suitability and Cost-Saving Tips

This therapy may suit adults who need a non-triptan option, including those with refractory migraine. It is not appropriate in pregnancy, during certain postpartum periods, or for people with significant vascular disease. Smokers and those with uncontrolled blood pressure need careful evaluation. Review all medicines, including herbal products, with your clinician.

To manage costs, consider:

• Multi-month fills — reduce per-order fees when appropriate.
• Refill reminders — set calendar alerts so you do not run short.
• Route planning — clinic IV therapy versus at-home injection per your prescriber.
• Pack sizes — single-dose options can reduce waste.

For travel, keep the carton and a copy of your prescription. Ask your clinician for a letter if you need to carry syringes. Use a sturdy case to protect vials and supplies.

Questions to Ask Your Clinician

• Is this treatment a good option given my heart and blood pressure history?
• Which route is best for me, and when should I use it during an attack?
• What are the daily and weekly limits for my plan, and how should I space doses?
• Should I take an anti-nausea medicine before the injection?
• How do I avoid interactions with triptans or other medications I use?
• What warning signs mean I should stop and seek urgent care?
• How can I track response to adjust my acute and preventive plan?

Authoritative Sources

FDA DailyMed — official labeling and Medication Guide

Health Canada Drug Product Database — Canadian product listings

Manufacturer Site — brand information for D.H.E. 45

Explore Related Topics

Learn more about migraine care in our resources: see Migraine, Cluster Headache, and our article Menstruation And Migraines. For broader context, explore National Migraine And Headache. Interested in supply origin? See Canada. Always defer to your prescriber and official labeling for individual guidance.

Ready when you are—add to cart for US shipping from Canada with prompt, express shipping. This content is for general information and does not replace professional medical advice.