Drug interactions
Dihydroergotamine + Ketoconazole
Severity: Contraindicated
Dihydroergotamine and Ketoconazole: 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
Ketoconazole markedly raises dihydroergotamine concentrations. This can cause severe peripheral and cerebral vasospasm and ischemia, including limb and bowel ischemia, and is a labeled contraindication.
What this interaction means in plain words
Dihydroergotamine and Ketoconazole 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; Ketoconazole belongs to Anti Fungals.
Why it happens
Strong inhibition of CYP3A4 by ketoconazole reduces the first-pass and systemic metabolism of dihydroergotamine.
What to do
Do not combine. Use a non-ergot migraine treatment, or an antifungal that does not strongly inhibit CYP3A4, if dihydroergotamine is needed.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Dihydroergotamine and Ketoconazole, 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 14 days on the web. No card needed.
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Disopyramide + Ketoconazole 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 Ketoconazole?
MediHelp rates the interaction as contraindicated. Dihydroergotamine and Ketoconazole 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. Ketoconazole markedly raises dihydroergotamine concentrations. This can cause severe peripheral and cerebral vasospasm and ischemia, including limb and bowel ischemia, and is a labeled contraindication.
How serious is the interaction between Dihydroergotamine and Ketoconazole?
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 combine. Use a non-ergot migraine treatment, or an antifungal that does not strongly inhibit CYP3A4, if dihydroergotamine is needed.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole 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.
