Drug interactions
Dihydroergotamine intranasal + Ketoconazole
Severity: Contraindicated
Dihydroergotamine intranasal and Ketoconazole: 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
Ketoconazole raises systemic exposure to dihydroergotamine even when it is given intranasally. This increases the risk of serious vasospasm and ischemia, and the combination is contraindicated in labeling.
What this interaction means in plain words
Dihydroergotamine intranasal and Ketoconazole 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
Strong CYP3A4 inhibition by ketoconazole reduces the metabolic clearance of dihydroergotamine.
What to do
Avoid the combination. Choose a non-ergot acute migraine therapy while ketoconazole is being used.
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 Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
- Disopyramide + Ketoconazole Contraindicated
Frequently asked questions
Can I take Dihydroergotamine intranasal with Ketoconazole?
MediHelp rates the interaction as contraindicated. Dihydroergotamine intranasal and Ketoconazole 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. Ketoconazole raises systemic exposure to dihydroergotamine even when it is given intranasally. This increases the risk of serious vasospasm and ischemia, and the combination is contraindicated in labeling.
How serious is the interaction between Dihydroergotamine intranasal and Ketoconazole?
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. Choose a non-ergot acute migraine therapy while ketoconazole is being used.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole page.
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