Drug interactions
Amitriptyline + Dihydroergotamine
Severity: Moderate
Amitriptyline and Dihydroergotamine: 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 using them together may theoretically increase the risk of serotonin syndrome. The main concern with dihydroergotamine is vasoconstriction, which may also be heightened by amitriptyline's noradrenergic effects. Amitriptyline is commonly used for migraine prophylaxis, so the combination is often encountered.
What this interaction means in plain words
Amitriptyline and Dihydroergotamine 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.
Amitriptyline belongs to Central Nervous System; Dihydroergotamine belongs to Central Nervous System.
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 avoid concurrent CYP3A4 inhibitors.
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
Other interactions of Dihydroergotamine
- Almotriptan + Dihydroergotamine Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
- Dihydroergotamine + Dopamine Contraindicated
- Dihydroergotamine + Dronedarone Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Dihydroergotamine + Eletriptan Contraindicated
Frequently asked questions
Can I take Amitriptyline with Dihydroergotamine?
MediHelp rates the interaction as moderate. Amitriptyline and Dihydroergotamine 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 using them together may theoretically increase the risk of serotonin syndrome. The main concern with dihydroergotamine is vasoconstriction, which may also be heightened by amitriptyline's noradrenergic effects. Amitriptyline is commonly used for migraine prophylaxis, so the combination is often encountered.
How serious is the interaction between Amitriptyline and Dihydroergotamine?
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 avoid concurrent CYP3A4 inhibitors.
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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