Drug interactions
Dihydroergotamine + Pimavanserin
Severity: Moderate
Dihydroergotamine and Pimavanserin: 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
Pimavanserin acts on serotonin receptors and dihydroergotamine has serotonergic activity, so use together carries a theoretical risk of serotonin toxicity. The dopaminergic effects of the antipsychotic may also add to neuroleptic-type reactions. Clinical evidence is limited.
What this interaction means in plain words
Dihydroergotamine and Pimavanserin 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; Pimavanserin belongs to Central Nervous System.
Why it happens
Theoretical additive serotonergic and dopaminergic modulation; pimavanserin is a 5-HT2A inverse agonist.
What to do
Monitor for serotonin toxicity (agitation, tremor, hyperthermia, clonus) and neuroleptic malignant syndrome. Educate patients to report these symptoms promptly.
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 Pimavanserin
- Lefamulin + Pimavanserin Contraindicated
- Pimavanserin + Pimozide Contraindicated
- Pimavanserin + Vandetanib Contraindicated
- Adagrasib + Pimavanserin Major
- Amiodarone + Pimavanserin Major
- Amisulpride + Pimavanserin 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 Pimavanserin?
MediHelp rates the interaction as moderate. Dihydroergotamine and Pimavanserin 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. Pimavanserin acts on serotonin receptors and dihydroergotamine has serotonergic activity, so use together carries a theoretical risk of serotonin toxicity. The dopaminergic effects of the antipsychotic may also add to neuroleptic-type reactions. Clinical evidence is limited.
How serious is the interaction between Dihydroergotamine and Pimavanserin?
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 serotonin toxicity (agitation, tremor, hyperthermia, clonus) and neuroleptic malignant syndrome. Educate patients to report these symptoms promptly.
What other medicines interact with Pimavanserin?
MediHelp also lists interactions of Pimavanserin with, for example, Lefamulin, Pimozide, Vandetanib. The full list is on the Pimavanserin page.
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