Drug interactions
Dihydroergotamine + Metronidazole
Severity: Moderate
Dihydroergotamine and Metronidazole: 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 toxicity (ergotism, vasospasm and ischemia) is a concern with strong CYP3A4 inhibitors. Metronidazole is not a strong inhibitor, but ergot reactions are severe, and isolated reports exist.
What this interaction means in plain words
Dihydroergotamine and Metronidazole 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; Metronidazole belongs to Anti Parasitic.
Why it happens
Possible weak CYP3A4 inhibition by metronidazole reducing dihydroergotamine clearance.
What to do
Monitor for peripheral ischemia, paresthesias, nausea and vasospasm; stop dihydroergotamine if they occur. Consider an alternative antibiotic if symptoms arise.
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?
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Other interactions of Metronidazole
- Ethanol + Metronidazole Contraindicated
- Metronidazole + Pimozide Contraindicated
- Amiodarone + Metronidazole Major
- Disulfiram + Metronidazole Major
- Ergotamine + Metronidazole Major
- Lomitapide + Metronidazole Major
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 Metronidazole?
MediHelp rates the interaction as moderate. Dihydroergotamine and Metronidazole 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 toxicity (ergotism, vasospasm and ischemia) is a concern with strong CYP3A4 inhibitors. Metronidazole is not a strong inhibitor, but ergot reactions are severe, and isolated reports exist.
How serious is the interaction between Dihydroergotamine and Metronidazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for peripheral ischemia, paresthesias, nausea and vasospasm; stop dihydroergotamine if they occur. Consider an alternative antibiotic if symptoms arise.
What other medicines interact with Metronidazole?
MediHelp also lists interactions of Metronidazole with, for example, Ethanol, Pimozide, Amiodarone. The full list is on the Metronidazole page.
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