Drug interactions
Dihydroergotamine intranasal + Imatinib
Severity: Major
Dihydroergotamine intranasal and Imatinib: major interaction.
Last updated Sources: UK SmPC
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
Imatinib inhibits CYP3A4 and may raise dihydroergotamine exposure. Excess dihydroergotamine can cause severe peripheral and cerebral vasospasm and ischemia. Labeling for dihydroergotamine contraindicates potent CYP3A4 inhibitors, and imatinib is a moderate inhibitor, so the risk is plausible but less established.
What this interaction means in plain words
Dihydroergotamine intranasal and Imatinib 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
Imatinib inhibits CYP3A4-mediated metabolism of dihydroergotamine, increasing ergot exposure.
What to do
Avoid the combination where possible and use a non-ergot acute migraine therapy. If unavoidable, monitor closely for numbness, coldness, tingling of the extremities, 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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References
Other interactions of Imatinib
- Imatinib + Lomitapide Contraindicated
- Imatinib + Lonafarnib Contraindicated
- Amobarbital + Imatinib Major
- Apalutamide + Imatinib Major
- Avapritinib + Imatinib Major
- Benzhydrocodone / acetaminophen + Imatinib Major
Frequently asked questions
Can I take Dihydroergotamine intranasal with Imatinib?
MediHelp rates the interaction as major. Dihydroergotamine intranasal and Imatinib 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. Imatinib inhibits CYP3A4 and may raise dihydroergotamine exposure. Excess dihydroergotamine can cause severe peripheral and cerebral vasospasm and ischemia. Labeling for dihydroergotamine contraindicates potent CYP3A4 inhibitors, and imatinib is a moderate inhibitor, so the risk is plausible but less established.
How serious is the interaction between Dihydroergotamine intranasal and Imatinib?
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 use a non-ergot acute migraine therapy. If unavoidable, monitor closely for numbness, coldness, tingling of the extremities, chest pain or severe headache.
What other medicines interact with Imatinib?
MediHelp also lists interactions of Imatinib with, for example, Lomitapide, Lonafarnib, Amobarbital. The full list is on the Imatinib page.
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