DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY
For 1 mL
Pharmacies pay
$29.44 – $49.63 filed
1 × $29.43546 to $49.63034 per ML (the 10 NDCs differ)
CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17
Medicare Part D paid
$149.46 filed
1 × $149.45629 per ML, Part D average
Medicare's price is not your price.
Medicare Part D · DSD_PTD_RY26_P04_V10_DY24_BGM.csv · eff. 2024-01-01 to 2024-12-31 · as of 2026-06-25 · retrieved 2026-10-18
The spread
3.0× – 5.1× estimated
Medicare paid between 3.0× and 5.1× what pharmacies pay, depending on the NDC.
Part D averages every strength and form sold under “Dihydroergotamine Mesylate*” / “Dihydroergotamine Mesylate” into one figure, so it is not specific to this NDC.
OpenBill calculation · DSD_PTD_RY26_P04_V10_DY24_BGM.csv + nadac-national-average-drug-acquisition-cost-20261014.csv · NADAC eff. 2026-09-23 (file of 2026-10-14, retrieved 2026-10-17) · Part D 2024-01-01 to 2024-12-31 (file of 2026-06-25, retrieved 2026-10-18)
Cost-plus estimate
$38.86 – $62.07 estimated
NADAC for the pack + 15% + $5.00 fee per fill
This is a model, not a price any pharmacy quoted. Shipping is not included. How it is worked out
OpenBill calculation · nadac-national-average-drug-acquisition-cost-20261014.csv · NADAC eff. 2026-09-23 (file of 2026-10-14, retrieved 2026-10-17)
Open the interactive card Change the quantity, type what you were charged, and see every record in full.
What it is
DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY is how the CMS NADAC file names this product. The FDA NDC Directory lists it as “dihydroergotamine mesylate” and “dihydroergotamine mesylate nasal”, as its NDCs’ listings variously write the nonproprietary name.
FDA gives its dosage form as “spray” and “spray, metered” and its route as nasal.
FDA lists 4 labelers (the companies named on the label) for its NDCs, among them Hikma Pharmaceuticals USA Inc., Cipla USA Inc. and Advagen Pharma Ltd.
FDA’s Established Pharmacologic Class for it is Ergotamine Derivative.
The NADAC file of 2026-10-14 prices it under 10 NDCs (National Drug Codes); the FDA directory lists 6 of them.
NADAC classes it as a generic drug (rate-setting class G), and does not mark it as sold over the counter.
What pharmacies pay
Pharmacies pay $29.44 – $49.63 for 1 mL, depending on the NDC ($29.43546 to $49.63034 per ML), by the CMS NADAC file of 2026-10-14; that price took effect on 2026-09-23. That is what pharmacies pay their suppliers, not what they charge you.
NADAC’s explanation codes for it: 1, calculated from the most recently completed pharmacy survey; 5, calculated based on package size.
What NADAC measures · NADAC explanation codes
The 4 labelers
| Labeler | NDCs | Pharmacies pay per unit |
|---|---|---|
| Advagen Pharma Ltd | 2 | $29.43546 to $49.63034 per ML filed |
| Cipla USA Inc. | 2 | $29.43546 to $49.63034 per ML filed |
| Hikma Pharmaceuticals USA Inc. | 1 | $29.43546 per ML filed |
| Trifluent Pharma, LLC | 1 | $29.43546 per ML filed |
| Not listed as a package in the FDA directory | 4 | $29.43546 to $49.63034 per ML filed |
All 10 NDCs, with labeler and price
- 24201-0463-01 · not listed as a package in the FDA directory · $49.63034 per ML · eff. 2026-09-23 filed
- 24201-0463-08 · Hikma Pharmaceuticals USA Inc. · $29.43546 per ML · eff. 2026-09-23 filed
- 69097-0503-27 · Cipla USA Inc. · $29.43546 per ML · eff. 2026-09-23 filed
- 69097-0503-31 · Cipla USA Inc. · $49.63034 per ML · eff. 2026-09-23 filed
- 72888-0096-19 · Advagen Pharma Ltd · $29.43546 per ML · eff. 2026-09-23 filed
- 72888-0096-34 · Advagen Pharma Ltd · $49.63034 per ML · eff. 2026-09-23 filed
- 73352-0096-18 · not listed as a package in the FDA directory · $49.63034 per ML · eff. 2026-09-23 filed
- 73352-0096-19 · Trifluent Pharma, LLC · $29.43546 per ML · eff. 2026-09-23 filed
- 76282-0680-43 · not listed as a package in the FDA directory · $49.63034 per ML · eff. 2026-09-23 filed
- 76282-0680-44 · not listed as a package in the FDA directory · $29.43546 per ML · eff. 2026-09-23 filed
Other strengths, forms and brands
1 other product in the NADAC file shares an FDA nonproprietary name with DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY.
| Product | Pharmacies pay per unit | Medicare per unit |
|---|---|---|
| DIHYDROERGOTAMINE 4 MG/ML SPRY | $29.43546 to $49.63034 per ML filed | $149.45629 per ML filed |
| DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY this page | $29.43546 to $49.63034 per ML filed | $149.45629 per ML filed |
Part D is one average per brand and generic name, over every strength and form.
CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17
Medicare Part D · DSD_PTD_RY26_P04_V10_DY24_BGM.csv · eff. 2024-01-01 to 2024-12-31 · as of 2026-06-25 · retrieved 2026-10-18
What Medicare paid
Medicare Part D paid $149.46 for 1 mL, at an average of $149.45629 per ML in 2024 (2024-01-01 to 2024-12-31) for “Dihydroergotamine Mesylate*” and “Dihydroergotamine Mesylate”, every strength and form sold under that name together (Medicare Part D Spending by Drug, file of 2026-06-25).
That average covers 17,794 Part D claims (fills, including refills) for 2024-01-01 to 2024-12-31, across every maker, strength and form under the name.
6 of the product’s 10 NDCs have this Medicare figure; the other 4 do not, and the interactive card says why for each.
Medicare's price is not your price.
What Part D spending measures · Which Medicare figure OpenBill compares · How the spread is worked out
What to ask at the counter
None of these figures is your price: what you pay depends on your pharmacy, your insurance, coupons and discounts.
- What is your cash price for 1 mL? Is it lower than what I would pay through my insurance?
- Which NDC (the 11-digit number on the package) is this? Pharmacies pay $29.43546 to $49.63034 per ML for this product, depending on the NDC.
- How much is in the package I am getting? This page uses 1 mL; your package may hold a different amount.
- If you have Medicare Part D: what is my plan’s copay or coinsurance for it? The Part D average on this page is not what you pay.
- These are questions about price, not medical advice. Do not change or stop a medicine without talking to your prescriber or pharmacist.
Questions
- Why is the comparison with Medicare for DIHYDROERGOTAMINE MESYLATE 4 MG/ML NASAL SPRAY labelled estimated?
- Beyond what the card shows, the records give these reasons: The Part D figure covers 2024-01-01 to 2024-12-31; the NADAC price is from the file of 2026-10-14. Part D spending basis, as the Part D record states it: Part D 2024 average spend per dosage unit for Dihydroergotamine Mesylate* / Dihydroergotamine Mesylate: all makers, strengths, forms and routes combined, claim-weighted; gross cost incl. dispensing fees and patient pay, before rebates. Unit taken as NADAC's ML. Joined on generic name. *: CMS says this average reflects multiple routes of administration, which may have different unit prices. Only NADAC NDCs whose FDA route includes NASAL point at this name (8 of the 10 the name join matched); NDCs of another route or with no known FDA route do not. 3 of the 8 NDCs that point at this name are not listed in the FDA NDC Directory as packages of their own; their route was taken from FDA's record for the same product (labeler and product code).
- Why does this page start at 1 mL?
- The FDA package descriptions of this product’s NDCs give different amounts (1 mL, 8 mL). So the card starts at 1 ML; change it to match your prescription.