Drug interactions
Amitriptyline + Dihydroergotamine intranasal
Severity: Moderate
Amitriptyline and Dihydroergotamine intranasal: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs have serotonergic effects, so combined use may theoretically increase the risk of serotonin syndrome. Dihydroergotamine also causes vasoconstriction, which may be enhanced by amitriptyline's noradrenergic action. The combination is often used in migraine care.
What this interaction means in plain words
Amitriptyline and Dihydroergotamine intranasal can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive serotonergic activity and potentiation of vasoconstriction via noradrenergic reuptake inhibition.
What to do
Monitor for serotonin toxicity such as agitation, tremor, hyperreflexia and hyperthermia, and for ischemic symptoms. Use the lowest effective doses and do not exceed labeled dihydroergotamine dosing.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Frequently asked questions
Can I take Amitriptyline with Dihydroergotamine intranasal?
MediHelp rates the interaction as moderate. Amitriptyline and Dihydroergotamine intranasal can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs have serotonergic effects, so combined use may theoretically increase the risk of serotonin syndrome. Dihydroergotamine also causes vasoconstriction, which may be enhanced by amitriptyline's noradrenergic action. The combination is often used in migraine care.
How serious is the interaction between Amitriptyline and Dihydroergotamine intranasal?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for serotonin toxicity such as agitation, tremor, hyperreflexia and hyperthermia, and for ischemic symptoms. Use the lowest effective doses and do not exceed labeled dihydroergotamine dosing.
What other medicines interact with Amitriptyline?
MediHelp also lists interactions of Amitriptyline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Amitriptyline page.
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