When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to ergotamine or caffeine, or if you are pregnant or plan to become pregnant. You should not use this medicine if you have high blood pressure, kidney disease, liver disease, heart disease, blood vessel disorders, or problems with circulation.

How to Use This Medicine:
Suppository

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to. Never take rectal suppositories by mouth.
• Wash your hands with soap and water before using this medicine. Remove the foil or wrapper from the suppository before inserting it.
• To make the suppository easier to insert, you may use a lubricating gel such as K-Y® Jelly, but do not use petroleum jelly (Vaseline®).
• Lie on your left side with your left leg straight or slightly bent, and your right knee bent upward. Gently push the pointed end of the suppository into the rectum about 1 inch.
• Keep lying down for about 15 minutes to keep the suppository from coming out before it melts. Then, wash your hands again.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using dopamine (Intropin®), sibutramine (Meridia®), antibiotics (such as Biaxin®, Dynabac®, Ery-Tab®), blood pressure medicine (such as atenolol, metoprolol, Inderal®, Toprol®), medicines to treat HIV/AIDS (Agenerase®, Crixivan®, Invirase®, Norvir®, Rescriptor®, Sustiva®, Viracept®), or other medicines to treat migraine headaches (Amerge®, Imitrex®, Maxalt®, Zomig™).
• Do not drink alcohol while you are using this medicine. Avoid caffeine (coffee, tea, soft drinks, chocolate).
• Smoking may make your headaches worse or increase the side effects of this medicine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are breastfeeding, or if you have a stomach ulcer, glaucoma, or history of a stroke.
• If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Fast or slow heartbeat
• Lightheadedness or fainting
• Numbness or tingling in your fingers or toes
• Pain or discomfort behind your breastbone
• Pain, itching, or irritation around your rectum
• Skin rash, swelling, or itching
• Vomiting, numbness, tingling feeling, or pain and blue discoloration of your hands and feet

If you notice these less serious side effects, talk with your doctor:

• Muscle pain
• Nausea, vomiting, diarrhea, or stomach pain
• Nervousness, irritability, dizziness
• Weakness in your legs

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088