Do not take this medicine with any of the following medications:
-antifungal drugs like fluconazole, itraconazole, ketoconazole or voriconazole
-certain antibiotics like erythromycin, clarithromycin, and troleandomycin
-cocaine
-conivaptan
-dexfenfluramine
-ephedrine
-feverfew
-grapefruit juice
-imatinib
-isoproterenol
-medicines called nitrates like isosorbide and nitroglycerin
-medicines for colds, flu, or breathing difficulties like phenylephrine and pseudoephedrine
-medicines for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan
-midodrine
-nefazodone
-other ergot alkaloids like bromocriptine, cabergoline, dihydroergotamine, ergoloid mesylates, ergonovine, methylergonovine, and methysergide
-some medicines for HIV

This medicine may also interact with the following medications:
-clotrimazole
-fluoxetine
-fluvoxamine
-medicines for high blood pressure, especially beta-blockers
-metronidazole
-nicotine
-zileuton

They need to know if you have any of these conditions:
-chest pain or difficulty breathing
-heart or blood vessel disease
-high blood pressure
-infection
-kidney disease
-liver disease
-poor circulation
-risk factors for heart disease such as smoking, high cholesterol, a family history of heart disease, or if you are postmenopausal or a male over 40 years of age
-an unusual or allergic reaction to dihydroergotamine, ergot alkaloids, other medicines, foods, dyes, or preservatives
-pregnant or trying to get pregnant
-breast-feeding

Check with your doctor or health care professional if you do not get relief from your headaches after using this medicine. You may need to be changed to a different kind of medicine to treat your migraines.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. To reduce dizzy or fainting spells, do not sit or stand up quickly, especially if you are an older patient. Alcohol can increase drowsiness, dizziness and flushing. Avoid alcoholic drinks.

This medicine decreases the circulation of blood to your skin, fingers, and toes. You may get more sensitive to the cold. Elderly patients are more likely to feel this effect. Dress warmly and avoid long exposure to the cold.

Keep out of the reach of children.

Store at room temperature below 25 degrees C (77 degrees F). Protect from light, moisture, and heat. Do not refrigerate or freeze. Keep the parts of the nasal spray in the tray provided. Keep this tray loaded in the assembly case. Do not keep an opened nasal spray for more than 8 hours. Throw away any unopened medicine after the expiration date.