Cerebral Vasospasm Associated with Clarithromycin-Ergotamine Combination

Cafergot is a widely used migraine abortive medication. It is a preparation containing ergotamine tartrate 1mg and caffeine 100 mg. Ergotism is one of rare serious side effects of ergot-based drugs such as ergotamine. Ergotism is defined as an intense arterial vasoconstriction, producing signs and symptoms of peripheral vascular ischemia such as numbness, tingling and pain in the extremities, cyanosis, absence of pulse, and if progressed untreated, gangrene may result. Furthermore ergotism can also involve signs and symptoms of vascular ischemia of other tissues such as renal or cerebral vasospasm [1]. The estimated incidence of ergotism in patients using ergot alkaloids is low, up to 0.002% [1-3].