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Drug interactions

Cyclosporin + Ergotamine

Severity: Major

Cyclosporin 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

Cyclosporine can raise ergotamine exposure, increasing the risk of ergotism. This presents as severe peripheral vasospasm, ischemia of the limbs, and cerebral or cardiac ischemia.

What this interaction means in plain words

Cyclosporin 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.

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

Evidence level: Moderate

Why it happens

Cyclosporine inhibits CYP3A4-mediated metabolism of ergotamine, increasing its systemic concentrations.

What to do

Avoid the combination and use a non-ergot migraine therapy such as a triptan or an analgesic. If it cannot be avoided, monitor closely for paresthesia, cold extremities and ischemic symptoms.

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 Ergotamine?

MediHelp rates the interaction as major. Cyclosporin 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. Cyclosporine can raise ergotamine exposure, increasing the risk of ergotism. This presents as severe peripheral vasospasm, ischemia of the limbs, and cerebral or cardiac ischemia.

How serious is the interaction between Cyclosporin 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 and use a non-ergot migraine therapy such as a triptan or an analgesic. If it cannot be avoided, monitor closely for paresthesia, cold extremities and ischemic symptoms.

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.

Full monographs, dosing and an interaction checker in the MediHelp app

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