Drug interactions
Dihydroergotamine intranasal + Fluoxetine
Severity: Major
Dihydroergotamine intranasal and Fluoxetine: 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
Serotonergic effects of both drugs may combine and raise the risk of serotonin syndrome. Fluoxetine may also modestly increase dihydroergotamine exposure through CYP3A4 inhibition, raising the risk of vasospasm.
What this interaction means in plain words
Dihydroergotamine intranasal and Fluoxetine 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
Additive serotonergic activity and possible CYP3A4 inhibition by fluoxetine.
What to do
Monitor for serotonin syndrome and signs of peripheral ischemia. Consider a non-ergot migraine therapy if the combination is poorly tolerated.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Dihydroergotamine intranasal with Fluoxetine?
MediHelp rates the interaction as major. Dihydroergotamine intranasal and Fluoxetine 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. Serotonergic effects of both drugs may combine and raise the risk of serotonin syndrome. Fluoxetine may also modestly increase dihydroergotamine exposure through CYP3A4 inhibition, raising the risk of vasospasm.
How serious is the interaction between Dihydroergotamine intranasal and Fluoxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for serotonin syndrome and signs of peripheral ischemia. Consider a non-ergot migraine therapy if the combination is poorly tolerated.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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