Amerge vs. Migranal

Amerge (naratriptan) and Migranal (dihydroergotamine mesylate) Spray are headache medicines used to treat migraine headaches. Amerge and Migranal will only treat a headache that has already begun. Amerge and Migranal will not prevent headaches or reduce the number of attacks. 

Amerge and Migranal are different types of migraine medications. Amerge is a 5HT agonist (a “triptan”) and Migranal is an ergot alkaloid.

Side effects of Amerge and Migranal that are similar include drowsiness, tired feeling/fatigue, and dizziness.

Side effects of Amerge that are different from Migranal include flushing (warmth, redness, or tingling under your skin), sensations of tingling/numbness/prickling/heat/warmth under your skin, weakness, and pressure or heavy feeling in any part of your body.

Side effects of Migranal that are different from Amerge include nasal congestion or irritation, changes in sense of taste, sore throat, nausea, vomiting, runny or stuffy nose, nosebleeds, headache, anxiety, depression, cold sweats, and pain, soreness, burning, tingling, or dryness in your nose or throat.

Both Amerge and Migranal may interact with other migraine headache medicines and antidepressants.

Amerge may also interact with medicines to treat psychiatric disorders, narcotics (opioids), and medicines to prevent nausea and vomiting.

Migranal may also interact with vasoconstrictors, beta-blockers, nicotine, oral contraceptives, HIV medications, antibiotics, and antifungals.

Common side effects of Amerge include:

• flushing,
• sensations of tingling/numbness/prickling/heat/warmth under your skin,
• weakness,
• drowsiness,
• tired feeling,
• dizziness, or
• pressure or heavy feeling in any part of your body

Common side effects of Migranal include:

• nasal congestion or irritation,
• changes in your sense of taste,
• sore throat,
• nausea,
• vomiting,
• dizziness,
• fatigue,
• runny or stuffy nose,
• nosebleeds,
• headache,
• drowsiness,
• anxiety,
• depression,
• cold sweats, or
• pain, soreness, burning, tingling, or dryness in your nose or throat.

Tell your doctor if you have serious side effects of Migranal Spray including:

• fast or slow heart rate;
• chest pain or heavy feeling, pain spreading to the arm or shoulder, and nausea, sweating, or general ill feeling;
• sudden numbness or weakness, sudden headache, confusion, or problems with vision, speech, or balance;
• muscle pain in your arms or legs, leg weakness;
• numbness or tingling and a pale or blue-colored appearance in your fingers or toes;
• swelling or itching in any part of your body;
• stomach cramps, diarrhea that may be bloody;
• cough with stabbing chest pain and trouble breathing; or
• dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Amerge (naratriptan) is a headache medicine used to treat migraine headaches. Amerge will only treat a headache that has already begun. Amerge will not prevent headaches or reduce the number of attacks. Amerge is available in generic form.

Migranal (dihydroergotamine mesylate) Spray is an ergot alkaloid medication used to treat active migraine headaches, with or without aura. Migranal Spray is only used to treat a migraine that has already started, and will not work to prevent a migraine if you have no symptoms.

Amerge may interact with other migraine headache medicines, or antidepressants. Tell your doctor all medications you use. Amerge should be used only when prescribed during pregnancy. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.

Migranal may interact with vasoconstrictors, sumatriptan, beta-blockers, nicotine, antidepressants, oral contraceptives, HIV medications, or antibiotics. Tell your doctor all medications and supplements you use. Do not use Migranal during pregnancy or while breastfeeding.

The dose of Migranal is 1 spray in each nostril followed in 15 minutes by an additional spray in each nostril, for a total of 4 sprays.