Ergotamine-induced Peripheral Ischaemia Reversed by Oral Thymoxamine Hydrochloride

Abstract

Although there is no generally accepted therapy for ergotamine-induced vasoconstriction, infusion of directly acting vasodilators is regarded presently as the treatment of choice. We present a case of peripheral arterial ischaemia secondary to excessive use of ergotamine suppositories, which was reversed with oral thymoxamine hydrochloride (an α₁-adrenoceptor antagonist) and ergotamine withdrawal. We suggest that in patients with ergotamine-induced peripheral arterial vasoconstriction with no evidence of gangrene, oral thymoxamine may be considered as a useful adjunct or possible alternative to infused vasodilator treatment.

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