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Drug interactions

Dihydroergotamine + Phenelzine

Severity: Major

Dihydroergotamine and Phenelzine: 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 has serotonergic activity and potent vasoconstrictor effects, so with an MAOI there is a risk of serotonin syndrome and hypertensive reactions. Headache treatment may therefore trigger severe adverse events.

What this interaction means in plain words

Dihydroergotamine and Phenelzine 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; Phenelzine belongs to Central Nervous System.

Evidence level: Low

Why it happens

Additive serotonergic effects, with MAO inhibition raising monoamine levels while DHE stimulates serotonin receptors and causes vasoconstriction.

What to do

Avoid the combination and choose a non-serotonergic migraine strategy. If it occurs, monitor blood pressure and for serotonin toxicity signs and stop DHE promptly.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Dihydroergotamine with Phenelzine?

MediHelp rates the interaction as major. Dihydroergotamine and Phenelzine 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 has serotonergic activity and potent vasoconstrictor effects, so with an MAOI there is a risk of serotonin syndrome and hypertensive reactions. Headache treatment may therefore trigger severe adverse events.

How serious is the interaction between Dihydroergotamine and Phenelzine?

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 and choose a non-serotonergic migraine strategy. If it occurs, monitor blood pressure and for serotonin toxicity signs and stop DHE promptly.

What other medicines interact with Phenelzine?

MediHelp also lists interactions of Phenelzine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Phenelzine page.

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