Answer
Apr 10, 2026 - 12:12 PM
The usual Migranal (dihydroergotamine mesylate) Nasal Spray dose for an acute migraine is:
- 1 spray (0.5 mg) into each nostril at the start of treatment.
- Wait 15 minutes, then use 1 additional spray in each nostril.
- This equals a total of 4 sprays (2 mg) for one migraine treatment. The FDA labeling notes that doses above 2 mg for a single migraine have not shown additional benefit.
The safety of using more than 3 mg (6 sprays) within 24 hours or 4 mg (8 sprays) within 7 days has not been established, and Migranal should not be used every day or for migraine prevention.
Before use, the pump is primed by spraying it 4 times, and the prepared applicator/opened vial should be discarded after 8 hours.
Also, Migranal should not be taken within 24 hours of triptans such as sumatriptan or other ergot-type migraine medicines because of the risk of excessive blood-vessel constriction.
