Dihydroergotamine Mesylate has 25 known drug interactions based on U.S. FDA drug labeling data. Of these, 13 are contraindicated combinations that should be avoided entirely. 2 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Clarithromycin, Erythromycin, Indinavir. Patients taking Dihydroergotamine Mesylate should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 25
- Contraindicated
- 13
- Major
- 2
- Moderate
- 10
Contraindicated (13)
- Dihydroergotamine Mesylate + Clarithromycin— Strong CYP3A4 inhibitor; rare reports of serious adverse events including vasospasm leading to cerebral ischemia and isc…
- Dihydroergotamine Mesylate + Erythromycin— Strong CYP3A4 inhibitor; rare reports of serious adverse events including vasospasm leading to cerebral ischemia and isc…
- Dihydroergotamine Mesylate + Indinavir— Strong CYP3A4 inhibitor; rare reports of serious adverse events including vasospasm leading to cerebral ischemia and isc…
- Dihydroergotamine Mesylate + Itraconazole— Strong CYP3A4 inhibitor; rare reports of serious adverse events including vasospasm leading to cerebral ischemia and isc…
- Dihydroergotamine Mesylate + Ketoconazole— Strong CYP3A4 inhibitor; rare reports of serious adverse events including vasospasm leading to cerebral ischemia and isc…
- Dihydroergotamine Mesylate + Macrolide Antibiotics— CYP 3A4 inhibitors increase dihydroergotamine exposure; contraindicated per prescribing information.
- Dihydroergotamine Mesylate + Mao Inhibitors— Contraindicated with CYP3A4 inhibitors including macrolide antibiotics and protease inhibitors.
- Dihydroergotamine Mesylate + Nelfinavir— Strong CYP3A4 inhibitor; rare reports of serious adverse events including vasospasm leading to cerebral ischemia and isc…
- Dihydroergotamine Mesylate + Peripheral Vasoconstrictors— Should not be used together; combination may cause synergistic elevation of blood pressure.
- Dihydroergotamine Mesylate + Protease Inhibitors— CYP 3A4 inhibitors increase dihydroergotamine exposure; contraindicated per prescribing information.
- Dihydroergotamine Mesylate + Ritonavir— Strong CYP3A4 inhibitor; rare reports of serious adverse events including vasospasm leading to cerebral ischemia and isc…
- Dihydroergotamine Mesylate + Sumatriptan— Should not be taken within 24 hours of each other; both cause coronary artery vasospasm with additive effects.
- Dihydroergotamine Mesylate + Triptans— Serotonin 5-HT1B/1D receptor agonists; additive coronary artery vasospasm risk; do not use within 24 hours of each other…
Major (2)
- Dihydroergotamine Mesylate + Nicotine— Nicotine may provoke vasoconstriction, predisposing to greater ischemic response to ergot therapy.
- Dihydroergotamine Mesylate + Propranolol— May potentiate vasoconstrictive action of dihydroergotamine by blocking vasodilating property of epinephrine.
Moderate (10)
- Dihydroergotamine Mesylate + Cotrimoxazole— Administer moderate CYP3A4 inhibitors (e.g., saquinavir, nefazodone, fluconazole, grapefruit juice, fluoxetine, fluvoxam…
- Dihydroergotamine Mesylate + Fluconazole— Administer moderate CYP3A4 inhibitors (e.g., saquinavir, nefazodone, fluconazole, grapefruit juice, fluoxetine, fluvoxam…
- Dihydroergotamine Mesylate + Fluoxetine— Weakness, hyperreflexia, and incoordination may occur rarely with coadministration of selective serotonin reuptake inhib…
- Dihydroergotamine Mesylate + Fluvoxamine— Weakness, hyperreflexia, and incoordination may occur rarely with coadministration of selective serotonin reuptake inhib…
- Dihydroergotamine Mesylate + Grapefruit Juice— Moderate CYP3A4 inhibitor; administer with caution due to potential vasospasm risk.
- Dihydroergotamine Mesylate + Nefazodone— Moderate CYP3A4 inhibitor; administer with caution due to potential vasospasm risk.
- Dihydroergotamine Mesylate + Paroxetine— Weakness, hyperreflexia, and incoordination may occur rarely with coadministration of selective serotonin reuptake inhib…
- Dihydroergotamine Mesylate + Saquinavir— Administer moderate CYP3A4 inhibitors (e.g., saquinavir, nefazodone, fluconazole, grapefruit juice, fluoxetine, fluvoxam…
- Dihydroergotamine Mesylate + Sertraline— Weakness, hyperreflexia, and incoordination may occur rarely with coadministration of selective serotonin reuptake inhib…
- Dihydroergotamine Mesylate + Zileuton— Moderate CYP3A4 inhibitor; administer with caution due to potential vasospasm risk.