Drug interactions
Cimetidine + Dihydroergotamine
Severity: Major
Cimetidine and Dihydroergotamine: 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
Cimetidine may increase dihydroergotamine concentrations. Elevated levels raise the risk of ergotism, with peripheral vasospasm and ischemia.
What this interaction means in plain words
Cimetidine and Dihydroergotamine 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.
Cimetidine belongs to Gastrointestinal Tract; Dihydroergotamine belongs to Central Nervous System.
Why it happens
Cimetidine inhibits CYP3A4, reducing the metabolism of dihydroergotamine.
What to do
Avoid the combination where possible and choose famotidine or another non-inhibiting acid suppressant. If used together, monitor for numbness, tingling, cold extremities, nausea and chest or limb 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 Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
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 Cimetidine with Dihydroergotamine?
MediHelp rates the interaction as major. Cimetidine and Dihydroergotamine 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. Cimetidine may increase dihydroergotamine concentrations. Elevated levels raise the risk of ergotism, with peripheral vasospasm and ischemia.
How serious is the interaction between Cimetidine and Dihydroergotamine?
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 famotidine or another non-inhibiting acid suppressant. If used together, monitor for numbness, tingling, cold extremities, nausea and chest or limb pain.
What other medicines interact with Cimetidine?
MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine page.
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