Drug interactions
Dihydroergotamine + Nitroglycerin
Severity: Major
Dihydroergotamine and Nitroglycerin: 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
Dihydroergotamine causes vasoconstriction that opposes nitroglycerin's vasodilation and may worsen myocardial ischemia. Nitrates may also raise ergot bioavailability by reducing its first-pass metabolism, increasing vasospasm risk. Angina patients are particularly at risk.
What this interaction means in plain words
Dihydroergotamine and Nitroglycerin 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; Nitroglycerin belongs to Cardiovascular.
Why it happens
Opposing vasoactive effects, with possible increased dihydroergotamine exposure caused by nitrates.
What to do
Avoid dihydroergotamine in patients needing nitrates for coronary disease and use an alternative migraine therapy. If both are given, monitor for chest pain and ischemic symptoms.
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 Nitroglycerin
- Avanafil + Nitroglycerin Contraindicated
- Nitroglycerin + Riociguat Contraindicated
- Nitroglycerin + Sildenafil Contraindicated
- Nitroglycerin + Tadalafil Contraindicated
- Nitroglycerin + Vardenafil Contraindicated
- Dihydroergotamine intranasal + Nitroglycerin 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 Nitroglycerin?
MediHelp rates the interaction as major. Dihydroergotamine and Nitroglycerin 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 causes vasoconstriction that opposes nitroglycerin's vasodilation and may worsen myocardial ischemia. Nitrates may also raise ergot bioavailability by reducing its first-pass metabolism, increasing vasospasm risk. Angina patients are particularly at risk.
How serious is the interaction between Dihydroergotamine and Nitroglycerin?
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 dihydroergotamine in patients needing nitrates for coronary disease and use an alternative migraine therapy. If both are given, monitor for chest pain and ischemic symptoms.
What other medicines interact with Nitroglycerin?
MediHelp also lists interactions of Nitroglycerin with, for example, Avanafil, Riociguat, Sildenafil. The full list is on the Nitroglycerin page.
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