Drug interactions
Dihydroergotamine intranasal + Diltiazem
Severity: Major
Dihydroergotamine intranasal and Diltiazem: 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
Diltiazem can raise dihydroergotamine exposure. Higher levels increase the risk of ergotism, with peripheral and cerebral vasospasm and ischemia. Severe ischemic complications are a recognized danger with CYP3A4 inhibitors and ergot derivatives.
What this interaction means in plain words
Dihydroergotamine intranasal and Diltiazem 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.
Why it happens
Diltiazem inhibits CYP3A4, reducing the metabolism of dihydroergotamine.
What to do
Avoid the combination where possible and choose another migraine therapy. If it cannot be avoided, monitor closely for numbness, coldness or pain in the extremities, and for chest pain or severe headache.
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 Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
Frequently asked questions
Can I take Dihydroergotamine intranasal with Diltiazem?
MediHelp rates the interaction as major. Dihydroergotamine intranasal and Diltiazem 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. Diltiazem can raise dihydroergotamine exposure. Higher levels increase the risk of ergotism, with peripheral and cerebral vasospasm and ischemia. Severe ischemic complications are a recognized danger with CYP3A4 inhibitors and ergot derivatives.
How serious is the interaction between Dihydroergotamine intranasal and Diltiazem?
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 choose another migraine therapy. If it cannot be avoided, monitor closely for numbness, coldness or pain in the extremities, and for chest pain or severe headache.
What other medicines interact with Diltiazem?
MediHelp also lists interactions of Diltiazem with, for example, Flibanserin, Ivabradine, Lomitapide. The full list is on the Diltiazem page.
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