Ergotamine/Belladonna Alkaloids/Phenobarbital, Oral

What are other names for this medicine?

Type of medicine: ergot alkaloid combination; anticholinergic

Generic and brand names: ergotamine, belladonna alkaloids, and phenobarbital, oral; ergotamine, caffeine, belladonna alkaloids, and pentobarbital, oral; Bellergal-S; Bellamine; Bellamine S; Bellaspas; Cafatine PB

What is this medicine used for?

This medicine is taken by mouth to treat:

• menopausal symptoms such as hot flushes, sweats, restlessness, and trouble sleeping
• migraine or cluster headaches
• certain heart/blood vessel disorders such as heart palpitations or rapid heart rate
• stomach/intestinal disorders such as "nervous stomach".

It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a stroke
• asthma
• glaucoma
• heart disease or circulation problems
• high blood pressure
• kidney or liver disease
• muscle diseases such as myasthenia gravis
• porphyria (nerve pain or sensitivity to sunlight)
• stomach or duodenal ulcers.

Females of childbearing age: Do not take this medicine if you are pregnant. This medicine has been reported to cause birth defects. Stop taking this medicine at the first sign that you may be pregnant and contact your healthcare provider right away. Do not breast-feed while taking this medicine.

How do I use it?

Use this medicine exactly as your healthcare provider prescribes. Do not use more or use it more often than prescribed. Taking too much of this medicine may cause serious reactions. For best results, use the medicine at the first sign of a migraine, then lie down in a dark, quiet room.

What should I watch out for?

Alcohol can make headaches worse. Do not drink alcohol during migraines.

This medicine may cause drowsiness, dizziness, or blurred vision. Do not drive or operate machinery unless you are fully alert and can see clearly.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. While you are taking this medicine, avoid long exposure to the sun. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. Do not use a sunlamp. If you get a severe sunburn, contact your healthcare provider right away.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Chest pain, vision problems, confusion, anxiety, depression, numbness or tingling of fingers or toes, body aches, cold hands or feet, skin blisters, weakness, fast or slow heartbeat.

Other: Dizziness, diarrhea, constipation, nausea, vomiting, dry skin, dry mouth.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antacids such as Maalox or Mylanta (separate by 2 to 3 hours)
• antibiotics such as erythromycin (E.E.S) and clarithromycin (Biaxin)
• antidepressants such as fluoxetine (Prozac), paroxetine (Paxil), amitriptyline, nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), doxepin (Sinequan), sertraline (Zoloft), and nefazodone
• antifungal medicines such as clotrimazole (Mycelex), fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• antihistamines found in many cold and allergy medicines such as diphenhydramine (Benadryl), and chlorpheniramine (Chlor-Trimeton)
• anti-HIV medicines such as ritonavir (Norvir), amprenavir (Agenerase), and nelfinavir (Viracept)
• antiseizure medicines such as phenytoin (Dilantin), carbamazepine (Tegretol), and valproic acid (Depakene)
• beta blockers such as propranolol (Inderal), sotalol (Betapace), and carvedilol (Coreg)
• blood thinners such as warfarin (Coumadin)
• digoxin (Lanoxin, Lanoxicaps)
• estrogens (including birth control pills)
• isoniazid (Nydrazid)
• MAO inhibitor antidepressants such as phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan) (Do not take an MAO inhibitor and this medicine within 14 days of each other.)
• other medicines to treat migraine headaches such as sumatriptan (Imitrex) and rizatriptan (Maxalt)
• phenothiazines such as promethazine (Phenergan), chlorpromazine (Thorazine), fluphenazine (Prolixin), thioridazine, and trifluoperazine (Stelazine)
• quinidine
• rifampin (Rifadin)
• sedatives or tranquilizers such as phenobarbital (Solfoton), butabarbital (Butisol), diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan), and alprazolam (Xanax)
• sibutramine (Meridia).

Do not eat grapefruit or drink grapefruit juice while taking this medicine.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicines in the trash.

Keep all medicines out of the reach of children.