Migranal (dihydroergotamine mesylate, USP) Nasal Spray is used to treat an active migraine headache with or without aura. Do not use it to try to prevent a migraine if you have no symptoms, to treat a common tension headache, or to treat a migraine that is not typical of your usual migraine.

Do not use Migranal Nasal Spray if you:

• Are taking certain anti-HIV medications
• Are taking a macrolide antibiotic such as troleandomycin, clarithromycin or erythromycin
• Are pregnant or nursing
• Have any disease affecting your heart, arteries or blood circulation
• Have taken other medications for the treatment or prevention of migraines within the last 24 hours
• Have severe liver or kidney disease
• Experience hemiplegic or basilar migraines, which often cause paralysis or impairment of speech

The use of Migranal^® Nasal Spray should not exceed dosing guidelines and should not be used on a daily basis.

Serious cardiac (heart) events, including some that have been fatal, have occurred following use of injectable dihydroergotamine, the active ingredient in Migranal Nasal Spray, but are extremely rare.

The most commonly reported side effects in clinical studies with Migranal Nasal Spray were runny nose or congestion, altered sense of taste, application site reactions, dizziness, nausea and vomiting.

You are encouraged to report adverse side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call1-800-FDA-1088.

Please see the accompanying full Prescribing Information, including Information for the Patient and boxed Warning.