How does it work?
Deseril tablets contain the active ingredient methysergide, which is a type of medicine called an ergot alkaloid. It is used in the prevention of migranes.
Although the cause of migraine attacks is not fully understood, it is thought that the widening of blood vessels in the brain causes the pain associated with migraine attacks.
It is also believed that a chemical called serotonin (also known as 5HT) is released in the brain at the beginning of an attack. Serotonin triggers the release of other chemicals which cause blood vessels in the brain to widen. Serotonin itself causes blood vessels in the brain to narrow.
Methysergide blocks serotonin (or 5HT) receptors in the brain. Blocking these receptors stops blood vessels in the brain from dilating and contracting. By stopping these changes methysergide helps prevent migraines from occuring. It reduces the frequency and severity of attacks of migraine and other types of vascular headache such as cluster headaches. However, the medicine won't stop an attack once it has started.
Methysergide can cause severe side effects and is only used if other treatment options have failed, or the headaches are so severe or regular that normal daily activities are severely affected and this level of treatment is warranted.
Methysergide is also used to treat diarrhoea in a condition called carcinoid syndrome. Carcinoid syndrome is caused by the release of serotonin from carcinoid tumours that are usually found in the intestines. The serotonin causes various symptoms, including diarrhoea. By blocking serotonin receptors in the gut, methysergide controls this diarrhoea.
What is it used for?
- Prevention of migraines.
- Prevention of cluster headaches and other vascular headaches.
- Diarrhoea caused by the release of serotonin from carcinoid tumors of the intestines (carcinoid disease).
- Deseril tablets should be taken with food.
- This medication may cause drowsiness, dizziness, or disturbances in vision. If affected do not drive or operate machinery. Avoid alcoholic drink.
- You should not smoke while taking this medicine, as this could increase the risk of side effects.
- This medicine can sometimes cause spasms in the arteries that could restrict blood flow to certain organs. For this reason you should stop taking this medicine and tell your doctor immediately if you experience any of the following symptoms during treatment: problems passing urine; an unexpected decrease in the amount of urine passed; pain in your lower back or chest; shortness of breath; pain, coldness or numbness in your legs or arms; severe abdominal pain; or loss of vision.
- Regular clinical supervision and periodic breaks from treatment are essential so that any adverse effects of this medicine can be recognised and minimised. This medicine should not be taken for longer than six months at a time without a break of at least one month.
- Your doctor will ask you to have regular check-ups during treatment so that your heart, lungs, blood vessels and other organs can be monitored.
- When stopping treatment this should be done gradually over two to three weeks to avoid rebound headaches. Follow the instructions given by your doctor.
- This medicine should not be used to treat a migrane attack.
Use with caution in
Not to be used in
- A type of migraine where there is a disturbance in brain function which initially presents with total blindness followed by dizziness, speach disturbances, ringing in the ears and double vision (basilar migraine).
- A form of migraine associated with temporary paralysis of one side of the body (hemiplegic migraine).
- Inflammatory condition of the temporal artery, which can lead to stroke or blindness. Symptoms include headaches and tenderness over the temples (temporal arteritis).
- Heavy smokers.
- Decreased kidney function.
- Decreased liver function.
- Very high blood pressure (severe hypertension).
- Coronary heart disease.
- Valvular heart disease.
- Progressive hardening of the arteries (arteriosclerosis).
- Hardening of the arteries in the legs (peripheral vascular disease).
- Inflammation of the veins in the legs (phlebitis).
- Inflammation of connective tissue (commonly the skin) of the legs (cellulitis).
- Diseases affecting connective tissue, eg scleroderma, systemic lupus erythematosus, rheumatoid arthritis (collagen vascular diseases).
- Diseases of the urinary tract in which there is obstruction to the passing of urine.
- Condition in which there is scarring and stiffening of the lungs (pulmonary fibrosis).
- History of disorders involving scarring and stiffening of body tissues (fibrosis, for example retroperitoneal fibrosis) caused by a medicine.
- Septic conditions, eg severe infections.
- General weight loss, malnutrition and wasting occurring in the course of a chronic disease or emotional disturbance (cachectic conditions).
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should not be used during pregnancy as it may be harmful to a developing baby. Seek further medical advice from your doctor.
- This medicine may pass into breast milk. It should not be used by women who are breastfeeding as it could be harmful to a nursing infant. Seek further medical advice from your doctor.
- Take this medication with or after food.
- This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Disturbances of the gut such as heartburn, diarrhoea, constipation, nausea, vomiting or abdominal pain.
- Excessive fluid retention in the body tissues, resulting in swelling (oedema).
- Difficulty in sleeping (insomnia).
- Leg cramps.
- Weight gain.
- Hair loss.
- Spasm of the arteries in a limb, this may cause symptoms such as coldness, loss of feeling or pain in an arm or leg.
- Spasm of the arteries in the heart, causing angina-like chest pain.
- Spasm of the arteries to the eye, causing reversible loss of vision.
- Spasm of the arteries to the kidneys, causing a temporary rise in blood pressure.
- Spasm of the arteries to the intestines, causing abdominal pain.
- Mental or behavioural disturbances.
- Scarring or stiffening (fibrosis) of tissues in the heart valves, lungs, urinary tract or major blood vessels.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, always check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Other medicines and drugs that narrow the blood vessels or increase blood pressure (vasoconstrictors and vasopressors, eg ephedrine, phenylephrine, pseudoephedrine, nicotine, triptans, ergot alkaloids - see also below) should not be used by people taking this medicine, as they may increase the risk of serious side effects.
You should not take this medicine if you have taken any kind of triptan medicine, eg almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan or zolmitriptan, in the previous six hours. You should not take any triptan medicines until at least 24 hours after taking the last dose of this medicine.
If ergotamine or other ergot alkaloids are taken in combination with methysergide there may be an increased risk of persistant spasm in the major arteries. These medicines should not be used in combination with methysergide.
The following medicines should not be used in combination with this medicine, because they can increase the blood level of methysergide and increase the risk of its side effects:
- macrolide antibiotics (eg telithromycin, erythromycin, clarithromycin)
- protease or reverse transcriptase inhibitors for treating HIV infection (eg ritonavir, indinavir, nelfinavir, amprenavir, saquinavir)
- azole antifungals (eg ketoconazole, itraconazole, voriconazole)
There may be an increased risk of narrowing or the blood vessels in the arms and legs if methysergide is used in combination with beta-blockers. If you are taking this medicine in combination with a beta-blocker such as propranolol it is important to let your doctor know if you get cold, numb or painful hands or feet.
Other medicines containing the same active ingredient
There are currently no other medicines available in the UK that contain methysergide as the active ingredient.