Drug interactions
Dihydroergotamine + Fluvoxamine
Severity: Major
Dihydroergotamine and Fluvoxamine: major interaction.
Last updated Sources: US FDA label
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 is metabolised by CYP3A4, and inhibitors can raise its levels enough to cause peripheral vasospasm and ischemia. Fluvoxamine is a weaker CYP3A4 inhibitor than agents like macrolides or azole antifungals, but it also adds serotonergic effects.
What this interaction means in plain words
Dihydroergotamine and Fluvoxamine 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.
Dihydroergotamine belongs to Central Nervous System; Fluvoxamine belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4 by fluvoxamine may reduce dihydroergotamine clearance, with possible added serotonergic effects.
What to do
Avoid the combination where possible and use an alternative migraine therapy. If used, counsel on symptoms of ergotism such as cold, numb or painful extremities and stop the drugs if they appear.
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?
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References
Other interactions of Fluvoxamine
- Agomelatine + Fluvoxamine Contraindicated
- Alosetron + Fluvoxamine Contraindicated
- Fezolinetant + Fluvoxamine Contraindicated
- Fluvoxamine + Isocarboxazid Contraindicated
- Fluvoxamine + Mavacamten Contraindicated
- Fluvoxamine + Methylene blue 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 Fluvoxamine?
MediHelp rates the interaction as major. Dihydroergotamine and Fluvoxamine 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. Dihydroergotamine is metabolised by CYP3A4, and inhibitors can raise its levels enough to cause peripheral vasospasm and ischemia. Fluvoxamine is a weaker CYP3A4 inhibitor than agents like macrolides or azole antifungals, but it also adds serotonergic effects.
How serious is the interaction between Dihydroergotamine and Fluvoxamine?
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 where possible and use an alternative migraine therapy. If used, counsel on symptoms of ergotism such as cold, numb or painful extremities and stop the drugs if they appear.
What other medicines interact with Fluvoxamine?
MediHelp also lists interactions of Fluvoxamine with, for example, Agomelatine, Alosetron, Fezolinetant. The full list is on the Fluvoxamine page.
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