Subcutaneous and intramuscular injections are generally more effective than the nasal spray and can be self-administered by patients.

Efficacy is variable in the nasal spray form with relative bioavailability of 32% compared to injection.

[19] Contraindications for DHE include: pregnancy, renal or hepatic failure, coronary, cerebral, and peripheral vascular disease, hypersensitivity reactions, sepsis, and uncontrolled hypertension.

[7] In 2013 the European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) has recommended that medicines containing ergot derivatives no longer be used to treat several conditions involving problems with memory, sensation or blood circulation, or to prevent migraine headaches because the risks (increased risk of fibrosis and ergotism) were said to be greater than the benefits in these indications.

[22] Morning glory: Argyreia nervosa (Hawaiian Baby Woodrose), Ipomoea spp.

(Morning Glory, Tlitliltzin, Badoh Negro), Rivea corymbosa (Coaxihuitl, Ololiúqui)