Tofago

Tofago is an acute migraine headache relief medication manufactured by T.O. Pharma Co., Ltd. in Thailand. It contains two active ingredients: Ergotamine Tartrate 1 mg and Caffeine 100 mg.

This medication belongs to the Ergot Alkaloid class, which has been used to treat migraines for decades. It is highly effective for severe migraine headaches, especially when regular painkillers don't work.

Important: Tofago is a dangerous drug that must be used only as directed by a doctor or pharmacist. Never exceed the recommended dosage.

Tofago works through two main mechanisms:

1. Ergotamine Tartrate:

• Acts as an alpha-adrenergic blocking agent and partial agonist at 5-HT1B/1D receptors
• Causes abnormally dilated blood vessels in the brain (which cause migraine pain) to constrict
• Effectively reduces headache pain

2. Caffeine:

• Enhances the absorption of Ergotamine for faster action
• May contribute slightly to blood vessel constriction

The medication begins working within 30-60 minutes after taking it, and its effects last for several hours.

For Adults and Children 12 Years and Older

1. Take immediately when migraine symptoms begin — the sooner you take it, the better it works
2. Start with 2 tablets with water
3. If symptoms don't improve within 30 minutes, take 1 additional tablet every 30 minutes
4. Do not exceed 6 tablets per migraine attack
5. Do not exceed 10 tablets per week
6. Can be taken before, after, or with food
7. If you experience nausea, take with a light snack

For mild migraines: May start with 1 tablet, then add 1 tablet every 30 minutes as needed.

For Children 6-12 Years

• Not recommended due to insufficient safety data
• If necessary, must be under close medical supervision
• Dosage depends on doctor's discretion only

For Children Under 6 Years

• Do not use — no safety data available

For Patients with Underlying Conditions

• Severe kidney or liver impairment: Do not use
• Heart disease, uncontrolled high blood pressure, peripheral vascular disease: Do not use
• Elderly: Use with caution under medical supervision

Note: This medication is used only when symptoms occur. It is not a scheduled medication, so there is no "missed dose" scenario.

Common side effects:

• Nausea, vomiting, stomach pain
• Dizziness
• Numbness or tingling in hands and feet
• Palpitations or insomnia (from caffeine)

Symptoms requiring immediate medical attention:

• Severe chest pain or tightness
• Cold, pale, or bluish hands and feet
• Severe muscle pain in arms or legs
• Severe numbness in extremities

These symptoms may indicate Ergotism (drug toxicity), which is dangerous and requires immediate treatment.

Tofago can be ordered online at Intimo Life. Customers must register and consult with our pharmacist first to ensure this medication is safe and appropriate for you.

Since Tofago is a dangerous drug with many contraindications and drug interactions, pharmacist consultation before use is essential.

Do not use if you:

• Are pregnant (Pregnancy Category X) — may cause fetal abnormalities or miscarriage
• Are breastfeeding — drug passes into breast milk
• Are allergic to Ergotamine, Caffeine, or other ingredients
• Have heart disease or peripheral vascular disease
• Have uncontrolled high blood pressure
• Have severe liver or kidney impairment
• Are under 6 years old

Drugs that must NOT be taken together (life-threatening):

• Macrolide antibiotics such as Erythromycin, Clarithromycin
• Azole antifungals such as Ketoconazole, Itraconazole
• Protease inhibitors (antivirals)
• Triptans such as Sumatriptan (do not use within 24 hours before or after Tofago)

Other precautions:

• Do not use daily for migraine prevention
• Do not use more than 10 days per month to avoid medication overuse headache
• Avoid alcohol while using this medication
• Use caution with Beta-blockers such as Propranolol

What's the difference between Tofago and Cafergot?

Tofago and Cafergot are different brand names but contain the same formula: Ergotamine Tartrate 1 mg and Caffeine 100 mg. They have identical properties and effects.

Can Tofago be used to prevent migraines?

No. Tofago is only for treating migraines that have already started. Using it for prevention may lead to severe side effects and medication overuse headache.

Can I take Tofago with paracetamol?

Yes, there are no significant drug interactions. However, avoid using multiple painkillers unnecessarily. Consult a pharmacist first.

Can Tofago be addictive?

The drug itself is not addictive. However, using it too frequently (more than 10 days per month) may cause medication overuse headache, making headaches more severe and frequent.

What should I do if I take too much?

Overdose is a medical emergency. Go to the hospital immediately and bring the medication box or blister pack. Symptoms may include severe numbness, confusion, seizures, and loss of consciousness.

How should Tofago be stored?

Store in the original container, tightly closed, at temperatures below 30°C. Protect from sunlight and moisture.

• Thai FDA — Drug Database
• Drugs.com — Ergotamine and Caffeine
• MedlinePlus — Ergotamine
• UpToDate — Ergotamine: Drug Information