Methysergide maleate
Methysergide maleate (Sansert)
Methysergide maleate
(meth-ih- SIR-jyd)
Pregnancy Category: X Sansert (Rx)

Classification: Prophylactic for vascular headaches

Action/Kinetics: Semisynthetic ergot alkaloid derivative. May act by directly stimulating smooth muscle leading to vasoconstriction. Blocks the effects of serotonin, a powerful vasodilator believed to play a role in vascular headaches; it also inhibits the release of histamine from mast cells and prevents the release of serotonin from platelets. Has weak emetic and oxytocic activity. Onset: 1-2 days. Peak plasma levels: 60 ng/mL. Duration: 1-2 days. Excreted through the urine as unchanged drugs and metabolites.

Uses: Prevention or reduction of the intensity and frequency of vascular headache (in clients having one or more per week or in cases where headaches are so severe preventive therapy is indicated). Prophylaxis of vascular headache.

Contraindications: Severe renal or hepatic disease, severe hypertension, CAD, peripheral vascular disease, tendency toward thromboembolic disease, cachexia (profound ill health or malnutrition), severe arteriosclerosis, pulmonary disease, phlebitis or cellulitis of lower limbs, collagen diseases or fibrotic processs, debilitated states, valvular heart disease, infectious disease, or peptic ulcer. Use to terminate acute attacks. Pregnancy, lactation, use in children.

Special Concerns: Geriatric clients may be more affected by peripheral vasoconstriction leading to the possibility of hypothermia.

Side Effects: The drug is associated with a high incidence of side effects. Fibrosis: Retroperitoneal fibrosis, cardiac fibrosis, pleuropulmonary fibrosis Peyronie's-like disease. The fibrotic condition may result in vascular insufficiency in the lower legs. CV: Vasoconstriction of arteries leading to paresthesia, chest pain, abdominal pain, or extremities that are cold, numb, or painful. Tachycardia, postural hypotension. CNS: Dizziness, ataxia, drowsiness, vertigo, insomnia, euphoria, lightheadedness, and psychic reactions such as depersonalization, depression, and hallucinations. GI: N&V;, diarrhea, heartburn, abdominal pain, increased gastric acid, constipation. Hematologic: Eosinophilia, neutropenia. Other: Peripheral edema, flushing of face, skin rashes, transient alopecia, myalgia, arthralgia, weakness, weight gain, telangiectasia.

Drug Interactions: Methysergide inhibits narcotic analgesics.

How Supplied: Tablet: 2 mg

Dosage
?Tablets
Adults: Administer 4-8 mg/day in divided doses. Continuous administration should not exceed 6 months. May be readministered after a 3- to 4-week rest period.