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Drug interactions

Cyclosporin + Dihydroergotamine

Severity: Major

Cyclosporin 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

Cyclosporine may raise dihydroergotamine levels through CYP3A4 inhibition, raising the risk of ergotism, with peripheral and cerebral vasospasm and ischemia.

What this interaction means in plain words

Cyclosporin 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.

Cyclosporin belongs to Miscellaneous; Dihydroergotamine belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Inhibition of CYP3A4-mediated dihydroergotamine metabolism.

What to do

Avoid the combination and use a non-ergot migraine treatment. If it cannot be avoided, monitor closely for signs of vasospasm such as limb coldness, paresthesias and 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Cyclosporin with Dihydroergotamine?

MediHelp rates the interaction as major. Cyclosporin 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. Cyclosporine may raise dihydroergotamine levels through CYP3A4 inhibition, raising the risk of ergotism, with peripheral and cerebral vasospasm and ischemia.

How serious is the interaction between Cyclosporin 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 and use a non-ergot migraine treatment. If it cannot be avoided, monitor closely for signs of vasospasm such as limb coldness, paresthesias and chest pain.

What other medicines interact with Cyclosporin?

MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.

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