ROBERT D. HOELDTKE, M.D., Ph.D.; STEPHEN T. CAVANAUGH, B.A.; JOHN D. HUGHES, B.A.; MARCIA POLANSKY, Sc.D.
HOELDTKE RD, CAVANAUGH ST, HUGHES JD, POLANSKY M. Treatment of Orthostatic Hypotension with Dihydroergotamine and Caffeine. Ann Intern Med. 1986;105:168-173. doi: 10.7326/0003-4819-105-2-168
Download citation file:
Published: Ann Intern Med. 1986;105(2):168-173.
Eight patients with orthostatic hypotension were treated with subcutaneous dihydroergotamine. Two doses of the drug (6.5 and 13 µg/kg) or placebo were given in a random sequence at 0600 h, and blood pressures were measured hourly throughout the day with patients in both supine and upright positions. To assess the effect of postprandial hypotension on the therapeutic response to dihydroergotamine, we gave breakfast, lunch, and supper on a fixed schedule at 0900 h, 1200 h, and 1700 h. Dihydroergotamine had a pressor effect in seven of the eight patients during the fasting period (0600 h to 0900 h), but this agent did not counteract the hypotensive effect of eating. Concomitant administration of caffeine (250 mg, 30 minutes before breakfast), however, maintained the beneficial effect of dihydroergotamine during the postprandial period. The combination of subcutaneous dihydroergotamine and caffeine represents a new therapeutic option for patients with severe autonomic neuropathy.
Learn more about subscription options.
Register Now for a free account.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only