Drug interactions
Clarithromycin + Dihydroergotamine intranasal
Severity: Contraindicated
Clarithromycin and Dihydroergotamine intranasal: contraindicated 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
Even with intranasal use, systemic exposure to dihydroergotamine is sufficient that strong CYP3A4 inhibition by clarithromycin can cause ergotism, with severe vasospasm and ischemia of extremities and the CNS.
What this interaction means in plain words
Clarithromycin and Dihydroergotamine intranasal are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Clarithromycin inhibits CYP3A4 and decreases clearance of dihydroergotamine.
What to do
Do not coadminister; use an alternative antibiotic such as azithromycin and advise patients to report cold, numb or painful extremities immediately.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Frequently asked questions
Can I take Clarithromycin with Dihydroergotamine intranasal?
MediHelp rates the interaction as contraindicated. Clarithromycin and Dihydroergotamine intranasal are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Even with intranasal use, systemic exposure to dihydroergotamine is sufficient that strong CYP3A4 inhibition by clarithromycin can cause ergotism, with severe vasospasm and ischemia of extremities and the CNS.
How serious is the interaction between Clarithromycin and Dihydroergotamine intranasal?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister; use an alternative antibiotic such as azithromycin and advise patients to report cold, numb or painful extremities immediately.
What other medicines interact with Clarithromycin?
MediHelp also lists interactions of Clarithromycin with, for example, Astemizole, Avanafil, Cisapride. The full list is on the Clarithromycin page.
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