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Cook RO et al. – MAP0004 is a novel orally inhaled formulation of dihydroergotamine mesylate (DHE) currently in development that has been clinically observed to provide rapid (?10 minutes) therapeutic levels of DHE but with lower rates of adverse effects (dizziness, nausea, and paresthesia) compared with intravenous (IV) dosing...The mechanism by which nausea was experienced with IV DHE – yet not with MAP0004 – was not associated with classic nausea pathways/targets (dopamine, 5–HT3, or muscarinic receptors) or with peripheral action in the intestine via enterochromaffin cells. Importantly, the maximum DHE concentrations following MAP0004 administration were insufficient to interact with receptors implicated in cardiovascular (5–HT2B and beta1) and pulmonary effects (beta2, adenosine, muscarinic, and leukotriene).


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