Drug interactions
Dihydroergotamine + Midodrine
Severity: Major
Dihydroergotamine and Midodrine: major 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
Midodrine is an alpha-1 agonist that raises blood pressure, and dihydroergotamine is a potent vasoconstrictor. Used together they can produce marked hypertension and excessive peripheral or cerebral vasoconstriction.
What this interaction means in plain words
Dihydroergotamine and Midodrine 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; Midodrine belongs to Miscellaneous.
Why it happens
Additive alpha-adrenergic and vascular smooth muscle vasoconstrictor effects (pharmacodynamic synergism).
What to do
Avoid the combination where possible and choose an alternative. If both are unavoidable, monitor blood pressure closely and watch for ischemic symptoms such as cold extremities or severe headache.
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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Other interactions of Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Ergotamine + Midodrine 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 Midodrine?
MediHelp rates the interaction as major. Dihydroergotamine and Midodrine 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. Midodrine is an alpha-1 agonist that raises blood pressure, and dihydroergotamine is a potent vasoconstrictor. Used together they can produce marked hypertension and excessive peripheral or cerebral vasoconstriction.
How serious is the interaction between Dihydroergotamine and Midodrine?
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 choose an alternative. If both are unavoidable, monitor blood pressure closely and watch for ischemic symptoms such as cold extremities or severe headache.
What other medicines interact with Midodrine?
MediHelp also lists interactions of Midodrine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Midodrine page.
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