Drug interactions
Dihydroergotamine + Tramadol
Severity: Moderate
Dihydroergotamine and Tramadol: 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
Both drugs have serotonergic activity, so combining them may raise the risk of serotonin syndrome. Dihydroergotamine is also a CYP3A4 substrate, and tramadol is not a significant CYP3A4 inhibitor, so the concern is mainly pharmacodynamic. Features include agitation, tremor, hyperreflexia and hyperthermia.
What this interaction means in plain words
Dihydroergotamine and Tramadol 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; Tramadol belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects: tramadol inhibits serotonin and norepinephrine reuptake, and dihydroergotamine is an agonist at 5-HT1 receptors.
What to do
Monitor for signs of serotonin syndrome, particularly after dose changes. Stop one or both drugs if symptoms appear.
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 Tramadol
- Isocarboxazid + Tramadol Contraindicated
- Olanzapine / samidorphan + Tramadol Contraindicated
- Phenelzine + Tramadol Contraindicated
- Procarbazine + Tramadol Contraindicated
- Rasagiline + Tramadol Contraindicated
- Safinamide + Tramadol 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 Tramadol?
MediHelp rates the interaction as moderate. Dihydroergotamine and Tramadol 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. Both drugs have serotonergic activity, so combining them may raise the risk of serotonin syndrome. Dihydroergotamine is also a CYP3A4 substrate, and tramadol is not a significant CYP3A4 inhibitor, so the concern is mainly pharmacodynamic. Features include agitation, tremor, hyperreflexia and hyperthermia.
How serious is the interaction between Dihydroergotamine and Tramadol?
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 signs of serotonin syndrome, particularly after dose changes. Stop one or both drugs if symptoms appear.
What other medicines interact with Tramadol?
MediHelp also lists interactions of Tramadol with, for example, Isocarboxazid, Olanzapine / samidorphan, Phenelzine. The full list is on the Tramadol page.
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