Ergot derivatives for migraine

The FAA's CACI – Migraine and Chronic Headache Worksheet lists triptans, metoclopramide, ondansetron, promethazine, ubrogepant and rimegepant among its relief/rescue medications and does not name an ergot derivative; it says a detailed list of migraine medications and their no-fly times can be found in the FAA's pharmaceutical guidance on migraine medications, which is the sheet that lists the ergots. Both are quoted.

• dihydroergotamine: 48 hours after each dose: ground observation
• ergotamine + caffeine: 24 hours after each dose: ground observation

FAA rule for migraine medication: The FAA says migraine relief or rescue medication is acceptable when used occasionally and unacceptable for daily use, and that its post-dose observation time (no-fly warning) is based on the drug's half-life. It says that if several relief medications are needed on a recurring basis to stop symptoms, this is considered a complicated migraine, and the examiner should defer. For relief or rescue medication the worksheet lists, the FAA's CACI – Migraine and Chronic Headache Worksheet says the examiner can issue if the pilot meets all of its acceptable certification criteria, which include no more than one episode per month, no more than 2 outpatient clinic or urgent care visits for symptom exacerbation in the last 12 months (even if symptoms fully resolved), and no history of in-patient hospitalizations for headaches; it says narcotics, Fiorinal, Fioricet and Midrin are not acceptable for relief or rescue. FAA, Migraine Medication