Drug interactions
Dihydroergotamine + Duloxetine
Severity: Moderate
Dihydroergotamine and Duloxetine: 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
Dihydroergotamine has serotonin receptor agonist activity and duloxetine increases serotonin availability, so serotonin syndrome is a theoretical risk. Separately, dihydroergotamine is a CYP3A4 substrate, but duloxetine does not meaningfully inhibit CYP3A4. The serotonergic risk is considered low in practice but reports exist for triptans and ergots with antidepressants.
What this interaction means in plain words
Dihydroergotamine and Duloxetine 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.
Dihydroergotamine belongs to Central Nervous System; Duloxetine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects through 5-HT receptor agonism and serotonin reuptake inhibition.
What to do
Counsel the patient on symptoms of serotonin syndrome such as agitation, tremor, sweating and diarrhea. Monitor after starting or increasing either drug and stop treatment if symptoms occur.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Dihydroergotamine and Duloxetine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Duloxetine
- Duloxetine + Isocarboxazid Contraindicated
- Duloxetine + Linezolid Contraindicated
- Duloxetine + Methylene blue Contraindicated
- Duloxetine + Phenelzine Contraindicated
- Duloxetine + Procarbazine Contraindicated
- Duloxetine + Rasagiline Contraindicated
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 Dihydroergotamine with Duloxetine?
MediHelp rates the interaction as moderate. Dihydroergotamine and Duloxetine 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. Dihydroergotamine has serotonin receptor agonist activity and duloxetine increases serotonin availability, so serotonin syndrome is a theoretical risk. Separately, dihydroergotamine is a CYP3A4 substrate, but duloxetine does not meaningfully inhibit CYP3A4. The serotonergic risk is considered low in practice but reports exist for triptans and ergots with antidepressants.
How serious is the interaction between Dihydroergotamine and Duloxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Counsel the patient on symptoms of serotonin syndrome such as agitation, tremor, sweating and diarrhea. Monitor after starting or increasing either drug and stop treatment if symptoms occur.
What other medicines interact with Duloxetine?
MediHelp also lists interactions of Duloxetine with, for example, Isocarboxazid, Linezolid, Methylene blue. The full list is on the Duloxetine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
