Drug interactions
Dihydroergotamine + Ribociclib
Severity: Major
Dihydroergotamine and Ribociclib: major interaction.
Last updated Sources: US FDA label
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
Increased dihydroergotamine levels may cause ergotism with peripheral and cerebral vasospasm and ischemia. Ribociclib is a CYP3A4 inhibitor and also carries QT risk.
What this interaction means in plain words
Dihydroergotamine and Ribociclib 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; Ribociclib belongs to Oncology.
Why it happens
Ribociclib inhibits CYP3A4, decreasing dihydroergotamine metabolism and raising exposure.
What to do
Avoid the combination where possible and use an alternative migraine therapy. If unavoidable, use the lowest dose and monitor for ischemic symptoms such as limb coldness, paresthesia and chest pain.
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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References
Other interactions of Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib Contraindicated
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 Ribociclib?
MediHelp rates the interaction as major. Dihydroergotamine and Ribociclib 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. Increased dihydroergotamine levels may cause ergotism with peripheral and cerebral vasospasm and ischemia. Ribociclib is a CYP3A4 inhibitor and also carries QT risk.
How serious is the interaction between Dihydroergotamine and Ribociclib?
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 use an alternative migraine therapy. If unavoidable, use the lowest dose and monitor for ischemic symptoms such as limb coldness, paresthesia and chest pain.
What other medicines interact with Ribociclib?
MediHelp also lists interactions of Ribociclib with, for example, Amiodarone, Cisapride, Dofetilide. The full list is on the Ribociclib page.
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