Drug interactions
Clozapine + Ergotamine
Severity: Moderate
Clozapine and Ergotamine: 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
Ergotamine is a vasoconstrictor with serotonergic activity, and clozapine may add to serotonergic effects, creating a theoretical risk of serotonin toxicity. Clozapine's alpha-blockade could also interfere with the vascular effects of ergot alkaloids. Clinical reports of this pair are limited.
What this interaction means in plain words
Clozapine and Ergotamine 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.
Clozapine belongs to Central Nervous System; Ergotamine belongs to Central Nervous System.
Why it happens
Possible additive serotonergic effects and opposing vascular adrenergic actions.
What to do
Monitor for serotonin toxicity such as agitation, tremor, hyperthermia and neuromuscular hyperactivity, and for neuroleptic malignant syndrome. Review whether an alternative migraine therapy is feasible.
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 Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Other interactions of Ergotamine
- Almotriptan + Ergotamine Contraindicated
- Atazanavir + Ergotamine Contraindicated
- Clarithromycin + Ergotamine Contraindicated
- Cobicistat + Ergotamine Contraindicated
- Darunavir + Ergotamine Contraindicated
- Dihydroergotamine intranasal + Ergotamine Contraindicated
Frequently asked questions
Can I take Clozapine with Ergotamine?
MediHelp rates the interaction as moderate. Clozapine and Ergotamine 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. Ergotamine is a vasoconstrictor with serotonergic activity, and clozapine may add to serotonergic effects, creating a theoretical risk of serotonin toxicity. Clozapine's alpha-blockade could also interfere with the vascular effects of ergot alkaloids. Clinical reports of this pair are limited.
How serious is the interaction between Clozapine and Ergotamine?
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, hyperthermia and neuromuscular hyperactivity, and for neuroleptic malignant syndrome. Review whether an alternative migraine therapy is feasible.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
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