Drug interactions
Dihydroergotamine + Erythromycin
Severity: Contraindicated
Dihydroergotamine and Erythromycin: 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
Erythromycin markedly raises dihydroergotamine exposure, which can cause ergotism with severe peripheral and cerebral vasospasm and ischemia. This is a labeled contraindication with potent CYP3A4 inhibitors.
What this interaction means in plain words
Dihydroergotamine and Erythromycin 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.
Dihydroergotamine belongs to Central Nervous System; Erythromycin belongs to Anti Bacterial.
Why it happens
Erythromycin inhibits CYP3A4-mediated metabolism of dihydroergotamine.
What to do
Do not coadminister; use a non-interacting antibiotic such as azithromycin or a different class. Watch for numbness, cold extremities and ischemia if exposure occurs.
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 Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
- Ergotamine + Erythromycin 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 Erythromycin?
MediHelp rates the interaction as contraindicated. Dihydroergotamine and Erythromycin 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. Erythromycin markedly raises dihydroergotamine exposure, which can cause ergotism with severe peripheral and cerebral vasospasm and ischemia. This is a labeled contraindication with potent CYP3A4 inhibitors.
How serious is the interaction between Dihydroergotamine and Erythromycin?
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 a non-interacting antibiotic such as azithromycin or a different class. Watch for numbness, cold extremities and ischemia if exposure occurs.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Domperidone. The full list is on the Erythromycin page.
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