Drug interactions
Berotralstat + Ergotamine
Severity: Major
Berotralstat and Ergotamine: major 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
Berotralstat inhibits CYP3A4 and may raise ergotamine levels. Ergotamine has a narrow therapeutic index, and elevated exposure can cause severe peripheral and cerebral vasospasm and ischemia.
What this interaction means in plain words
Berotralstat and Ergotamine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Berotralstat belongs to Miscellaneous; Ergotamine belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4-mediated metabolism of ergotamine.
What to do
Avoid the combination where possible and choose an alternative migraine therapy. If unavoidable, use the lowest ergotamine dose and monitor for ischemic symptoms such as limb coldness, numbness or chest pain.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Ergotamine
- Almotriptan + Ergotamine Contraindicated
- Atazanavir + Ergotamine Contraindicated
- Clarithromycin + Ergotamine Contraindicated
- Cobicistat + Ergotamine Contraindicated
- Darunavir + Ergotamine Contraindicated
- Dihydroergotamine intranasal + Ergotamine Contraindicated
Other interactions of Berotralstat
Frequently asked questions
Can I take Berotralstat with Ergotamine?
MediHelp rates the interaction as major. Berotralstat and Ergotamine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Berotralstat inhibits CYP3A4 and may raise ergotamine levels. Ergotamine has a narrow therapeutic index, and elevated exposure can cause severe peripheral and cerebral vasospasm and ischemia.
How serious is the interaction between Berotralstat and Ergotamine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and choose an alternative migraine therapy. If unavoidable, use the lowest ergotamine dose and monitor for ischemic symptoms such as limb coldness, numbness or chest pain.
What other medicines interact with Ergotamine?
MediHelp also lists interactions of Ergotamine with, for example, Almotriptan, Atazanavir, Clarithromycin. The full list is on the Ergotamine page.
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