Drug interactions
Dihydroergotamine + Verapamil
Severity: Major
Dihydroergotamine and Verapamil: 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
Verapamil inhibits CYP3A4 and may increase dihydroergotamine concentrations. Elevated ergot levels can cause severe peripheral and cerebral vasospasm and ischemia. Labeling for dihydroergotamine contraindicates potent CYP3A4 inhibitors and caution is also warranted with moderate inhibitors.
What this interaction means in plain words
Dihydroergotamine and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits CYP3A4-mediated metabolism of dihydroergotamine, raising its exposure.
What to do
Avoid if possible and use an alternative migraine therapy. If used, monitor for numbness, coldness of extremities, 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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil 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 Verapamil?
MediHelp rates the interaction as major. Dihydroergotamine and Verapamil 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. Verapamil inhibits CYP3A4 and may increase dihydroergotamine concentrations. Elevated ergot levels can cause severe peripheral and cerebral vasospasm and ischemia. Labeling for dihydroergotamine contraindicates potent CYP3A4 inhibitors and caution is also warranted with moderate inhibitors.
How serious is the interaction between Dihydroergotamine and Verapamil?
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 if possible and use an alternative migraine therapy. If used, monitor for numbness, coldness of extremities, chest pain and ischemic symptoms.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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