Prescription medicine
Ergotamine Brand names: Ergomar
Ergotamine (Ergomar) is a prescription medicine with an FDA approval on record since 1960. A generic is approved and listed by 1 labeler, but in the October 7, 2026 NADAC survey pharmacies bought only the brand, at $43.46 per tablet (Ergomar 2 mg tablet sublingual).
- Generic approved
- Boxed warning
Check it at the source: the ergotamine FDA label on DailyMed (effective February 25, 2025, Pangea Pharmaceuticals LLC); the NDA 12102 record on Drugs@FDA; every ergotamine label on DailyMed.
Highlights of the record
FDA label of February 25, 2025; NDC Directory, Drugs@FDA and Orange Book, October 8, 2026; NADAC October 7, 2026
Serious and/or life-threatening peripheral ischemia has been associated with the coadministration of ergotamine tartrate with potent CYP 3A4 inhibitors including protease inhibitors and macrolide antibiotics. Because CYP 3A4 inhibition elevates the serum levels of ergotamine tartrate, the risk for vasospasm leading to cerebral ischemia and/or ischemia of the extremities is increased. Hence, concomitant use of these medications is contraindicated. (See also CONTRAINDICATIONS and WARNINGS section)
Used for
From the label: indications and usageErgomar ® is indicated as therapy to abort or prevent vascular headache, e.g., migraine, migraine variants or so-called "histaminic cephalalgia".
Forms and strengths
- 2 mg
Tablet.
On the market
- Earliest approval on file
- January 13, 1960 Medihaler Ergotamine, 3M; Drugs@FDA’s file, where older or withdrawn approvals can be missing
- Generic approvals
- 2 first July 29, 1982; 1 with a marketed status in Drugs@FDA
- Labelers listed (NDC)
- 1 of which 1 under generic applications, 0 under brand applications, repackagers included
Supply and safety
- Pharmacy cost (NADAC)
- $43.46 per tablet Ergomar 2 mg tablet sublingual
- Shortage (FDA)
- No current entry
- Recalls by its makers (FDA)
- No recall recorded
- FAERS reports
- 82 through July 30, 2026
What is ergotamine used for?
From the label: indications and usageErgomar ® is indicated as therapy to abort or prevent vascular headache, e.g., migraine, migraine variants or so-called "histaminic cephalalgia".
FDA pharmacologic class: Ergotamine Derivative.
Source: FDA drug label (Ergomar Sublingual), Pangea Pharmaceuticals LLC, effective February 25, 2025 (SPL set a9582fdb-7ddd-4f69-aa7a-66247cdb8c92), via openFDA; the full label on DailyMed
Is there a generic for ergotamine (Ergomar)?
The FDA approved the first generic ergotamine on July 29, 1982. 2 generic applications are approved; 1 of them carries a current (not discontinued) marketing status in Drugs@FDA; that status is not evidence that the generic is on sale.
FDA's NDC Directory lists ergotamine from 1 labeler under a generic (ANDA) application. A listing means the company has registered the product for sale; it does not show that every pharmacy stocks it. In the latest NADAC survey pharmacies bought only the brand, so a generic may not be on sale yet.
- 1960 earliest approval on file
- 1982 first generic approved
Source: Drugs@FDA, FDA NDC Directory and the Orange Book (openFDA bulk files, October 8, 2026)
What do pharmacies pay for ergotamine (Ergomar)?
In CMS's NADAC survey of October 7, 2026, pharmacies paid $43.46 per tablet (Ergomar 2 mg tablet sublingual), up 4% from $41.89 on October 8, 2025. The chart's scale runs from the lowest to the highest price shown, not from zero. NADAC is what retail pharmacies paid their wholesalers, per unit, in CMS's monthly survey; what a patient pays depends on insurance and the pharmacy.
- Ergomar 2 mg tablet sublingual (brand)
| Strength and form | Brand or generic | Pharmacy cost | 30 tablets, or one pen or vial | 12-month change |
|---|---|---|---|---|
| Ergomar 2 mg tablet sublingual | Brand | $43.46 per tablet | $1,303.83 | +4% |
Source: CMS National Average Drug Acquisition Cost (NADAC) survey, October 7, 2026: what retail pharmacies paid per unit; not a counter price
What does the ergotamine label say about other medicines?
The ergotamine label names 17 other medicines in its interaction, contraindication or warning sections. The labels of 33 other medicines name ergotamine. The sentences are the labels' own; a label lists what its studies and reports found, not every interaction.
| Medicine named | Section | What the label says |
|---|---|---|
| Caffeine | warnings | Fibrotic Complications There have been a few reports of patients on ergotamine tartrate and caffeine therapy developing retroperitoneal and/or pleuropulmonary fibrosis. |
| Clarithromycin | contraindications | CONTRAINDICATIONS Coadministration of ergotamine with potent CYP 3A4 inhibitors (ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin and troleandomycin) has been associated with acute ergot toxicity (ergotism) characterized by vasospasm and ischemia of the extremities ( See PRECAUTIONS: |
| Clotrimazole | warnings | … saquinavir, nefazodone, fluconazole, fluoxetine, grapefruit juice, fluvoxamine, zileuton, metronidazole, and clotrimazole. |
| Epinephrine | drug interactions | The beta-blocker Inderal (propranolol) has been reported to potentiate the vasoconstrictive action of ergotamine by blocking the vasodilating property of epinephrine. |
| Erythromycin | contraindications | CONTRAINDICATIONS Coadministration of ergotamine with potent CYP 3A4 inhibitors (ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin and troleandomycin) has been associated with acute ergot toxicity (ergotism) characterized by vasospasm and ischemia of the extremities ( See PRECAUTIONS: |
| Fluconazole | warnings | While these reactions have not been reported with less potent CYP 3A4 inhibitors, there is a potential risk for serious toxicity including vasospasm when these drugs are used with ergotamine. Examples of less potent CYP 3A4 inhibitors include: saquinavir, nefazodone, fluconazole, fluoxetine, grapefruit juice … |
| Fluoxetine | warnings | … with ergotamine. Examples of less potent CYP 3A4 inhibitors include: saquinavir, nefazodone, fluconazole, fluoxetine, grapefruit juice, fluvoxamine, zileuton, metronidazole, and clotrimazole. |
| Fluvoxamine | warnings | … less potent CYP 3A4 inhibitors include: saquinavir, nefazodone, fluconazole, fluoxetine, grapefruit juice, fluvoxamine, zileuton, metronidazole, and clotrimazole. |
| Itraconazole | contraindications | Because of the increased risk for ergotism and other serious vasospastic adverse events, ergotamine use is contraindicated with these drugs and other potent inhibitors of CYP 3A4 (e.g., ketoconazole, itraconazole) (See WARNINGS: |
| Ketoconazole | contraindications | Because of the increased risk for ergotism and other serious vasospastic adverse events, ergotamine use is contraindicated with these drugs and other potent inhibitors of CYP 3A4 (e.g., ketoconazole, itraconazole) (See WARNINGS: |
| Metronidazole | warnings | … inhibitors include: saquinavir, nefazodone, fluconazole, fluoxetine, grapefruit juice, fluvoxamine, zileuton, metronidazole, and clotrimazole. |
| Nefazodone | warnings | While these reactions have not been reported with less potent CYP 3A4 inhibitors, there is a potential risk for serious toxicity including vasospasm when these drugs are used with ergotamine. Examples of less potent CYP 3A4 inhibitors include: saquinavir, nefazodone, fluconazole, fluoxetine, grapefruit juice … |
| Nelfinavir | contraindications | CONTRAINDICATIONS Coadministration of ergotamine with potent CYP 3A4 inhibitors (ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin and troleandomycin) has been associated with acute ergot toxicity (ergotism) characterized by vasospasm and ischemia of the extremities ( See PRECAUTIONS: |
| Nicotine | drug interactions | Nicotine may provoke vasoconstriction in some patients, predisposing to a greater ischemic response to ergot therapy. |
Every other medicine the ergotamine label names
| Medicine named | Section | What the label says |
|---|---|---|
| Propranolol | drug interactions | The beta-blocker Inderal (propranolol) has been reported to potentiate the vasoconstrictive action of ergotamine by blocking the vasodilating property of epinephrine. |
| Ritonavir | contraindications | CONTRAINDICATIONS Coadministration of ergotamine with potent CYP 3A4 inhibitors (ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin and troleandomycin) has been associated with acute … |
| Zileuton | warnings | … nefazodone, fluconazole, fluoxetine, grapefruit juice, fluvoxamine, zileuton, metronidazole, and clotrimazole. |
Other labels that name ergotamine
Source: FDA drug label (Ergomar Sublingual), Pangea Pharmaceuticals LLC, effective February 25, 2025 (SPL set a9582fdb-7ddd-4f69-aa7a-66247cdb8c92), via openFDA; the full label on DailyMed
What do FAERS reports show for ergotamine?
The FDA Adverse Event Reporting System holds 82 reports that list ergotamine among the medicines taken, through July 30, 2026, each a report of something that happened, not proof the medicine caused it; 2 are coded as a death and 37 as a hospital stay. Counts follow how widely a medicine is used and watched, and they are not a measure of how risky it is.
The most reported reactions
Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026
What next?
- Other ergotamine derivatives
- the pharmacologic class, with prices and generics
- Ergotamine side effects
- the label's list beside FAERS reports
- Check an interaction
- what two or more labels say about each other