Methergine for Migraine Prevention

One of the medications your doctor may prescribe for migraine is Methergine (a brand name), otherwise known as methylergonovine maleate.  Usually used for postpartum hemorrhage (bleeding), you may wonder how this medication is used for migraine, particularly migraine prevention.

Methylergonovine maleate is known as a ergot psychedelic alkaloid.  You may be familiar with more common migraine medications with the word "ergot" in them (medications derived from the ergot fungi, as methylergonovine maleate often is), such as ergotamine (ie Cafergot) or dihydroergotamine (ie Migranal or DHE).

But these are generally used as abortives (when you have a migraine attack), whereas Methergine is usually used as a preventative.  It’s also related to another preventative – methysergide (ie Sansert and Deseril).  In fact, some doctors will use methylergonovine maleate in the place of methysergide, since it becomes methysergide in your body anyway.

Methergine influences blood flow because of the way it leads to blood vessel constriction.  It also changes serotonin use in the body (inhibiting or blocking its effects), which are known to relate to migraine (actually, this is related to the constriction).  But as with all migraine medications, there is some question about how exactly they work, and we’re relying on clinical studies to show us how well they do work.

Methylergonovine maleate is not usually tried for the length of time that most other migraine medication is given for (usually 3 months).  Your doctor will probably want to check on you after only 3 weeks or so.  Also, you will be taking breaks from the medication for 3-4 weeks after you’ve taken it for 6 months (to avoid the rare possibility of fibrosis).  Your doctor will want to supervise you closely, and she will probably want you to go off it slowly.

Occasionally, methylergonovine maleate will be given for other things besides various types of migraine.  Most notably, cluster headache.  Also, it can be given as an abortive for migraine, particularly when you have a migraine that just won’t stop.

Of course you’ll be talking to your doctor before taking this drug (a doctor who knows your medical history), but here are a few things to keep in mind.  This drug is generally not given during pregnancy.  Also, your doctor needs to know if you have hypertension (high blood pressure) or liver or kidney problems.  Be sure to tell your doctor if you experience side effects to this drug.  Finally, don’t take it with juice (especially grapefruit juice).

Methergine will be a long way from the top of the list of things your doctor will prescribe.  However, it’s also not at the bottom of the list.  If your doctor says you’ve tried everything, she’s wrong.  Please find another specialist who will keep working with you.

More information on Methergine

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9 comments… add one
  • Kim Oct 22, 2010

    I have had chronic migraine for 11 1/2 years now. This summer I was prescribed methergine. It is the first thing in the 11 1/2 years that has given me any true relief. It is by no means a magic bullet but it has managed to keep my pain level manageable and any severe pain much easier to treat. The one draw back that I have found is that since it is a ergot I’m not allowed to take any other ergot (DHE) or any triptans as an abortive. I have been very successful though in treating my pain with an NSAID since starting the methergine. My doctor told me I would have to take my month long “holiday” once a year and have scan and blood work to check for any fibrosis.

  • Kim Dec 2, 2011

    I know this is a little old but my daughter was just prescribed this medicine. She’s had a continuous headache since January 2, 2011 and just had a hospital stay where she had DHE treatments. This medicine is supposed to help keep the headache away but we shall see…none of the pharmacies carry this medicine so we have to wait until today to pick it up. Thank you for your information on it because I had no idea what it was or what it did.

  • Kim Dec 2, 2011


    Hope it works well for your daughter. It has been a true blessing for me.

  • Holley Mar 4, 2014

    i have always had migraine headaches that were manageable with abortives, until 15 years ago, when I had a migraine that lasted for 10 months in different severities, but never went completely away. After trying virtually everything – the final drug combination that took the pain away and has left me with infrequent migraines has been a mixture of topamax, prozac, and methergine. I have not had any problems with side effects from taking methergine. I must note that my dosages are small.

  • Jackie Jan 30, 2015

    My daughter just started Methergine yesterday after trying so many things for 6 years! She’s inly 15. Still don’t know what her trigger is. We are praying this med is what will giver her her life back, instead of bedridden at the she of 15. I will keep you guys posted.

  • Cheryl Mar 11, 2015

    i have had migraines for years. My trigger is cigarette smoke either in the air,on clothes or on a person. Has anyone tried methergine with that trigger?

  • Lorrie Jun 29, 2015

    Methergine, had given me my life back, the results were AMAZING! only this is now my current insurance will only pay about half of the cost, meaning now this will cost me about $1200 a month, which I can’t afford. One of the pharmacies said to look into intravenous, shots… Anyone ever try this? Thanks!

  • Kim Jul 5, 2015

    Lorrie, have you checked with insurance to see if they will pay more for a smaller amount? My insurance refuses to pay anything for a full months supply, however they will pay for all but my regular copay for a 2 week supply. I end up paying a double copay each month, but I don’t complain when my copay is just a small fraction of the overall cost. Check with insurance to see if this is something you could do.

  • Jackie Jul 5, 2015

    Hi Lorrie, I’m so sorry that nsurance doesn’t cover well, all insurances are so different. So Lilly has been taken off the methergine pills and placed on Nimodipine and migranal nasal spray.
    Which works pretty good. She’s also on DHE shots that we can do at home. Insurance might cover that better than the pills? DHE it’s cheap either though because it is an Ergot so is migranal. You can’t take imitrex or any kind of sumatriptan with it. Can they possibly do a generic brand? Take care.

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