Drug interactions
Dihydroergotamine intranasal + Fluconazole
Severity: Contraindicated
Dihydroergotamine intranasal and Fluconazole: contraindicated 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
Fluconazole can raise dihydroergotamine exposure through CYP3A4 inhibition, even with intranasal use. This raises the risk of ergotism with vasospasm and limb or cerebral ischemia.
What this interaction means in plain words
Dihydroergotamine intranasal and Fluconazole are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Inhibition of CYP3A4-mediated dihydroergotamine metabolism by fluconazole.
What to do
Avoid the combination and use an alternative acute migraine treatment during fluconazole therapy. Stop dihydroergotamine and seek urgent care if numbness, coldness or pain in the extremities develops.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Fluconazole
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole Contraindicated
- Fluconazole + Levoketoconazole Contraindicated
Frequently asked questions
Can I take Dihydroergotamine intranasal with Fluconazole?
MediHelp rates the interaction as contraindicated. Dihydroergotamine intranasal and Fluconazole are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Fluconazole can raise dihydroergotamine exposure through CYP3A4 inhibition, even with intranasal use. This raises the risk of ergotism with vasospasm and limb or cerebral ischemia.
How serious is the interaction between Dihydroergotamine intranasal and Fluconazole?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use an alternative acute migraine treatment during fluconazole therapy. Stop dihydroergotamine and seek urgent care if numbness, coldness or pain in the extremities develops.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine, Dofetilide, Dronedarone. The full list is on the Fluconazole page.
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