Drug interactions
Dihydroergotamine intranasal + Phenelzine
Severity: Major
Dihydroergotamine intranasal and Phenelzine: 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
Combining a non-selective MAOI with dihydroergotamine may raise serotonergic and vasoconstrictive activity. This could lead to serotonin toxicity or marked blood pressure elevation. Ergot vasoconstriction is also a concern in its own right.
What this interaction means in plain words
Dihydroergotamine intranasal and Phenelzine 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
MAO inhibition increases monoamine levels and may add to the serotonergic and vasoconstrictor effects of dihydroergotamine.
What to do
Avoid the combination and choose another acute migraine therapy while the patient is taking phenelzine. If an ergot is unavoidable, monitor blood pressure and for signs of serotonin toxicity.
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 Phenelzine
- 5-HTP + Phenelzine Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amoxapine + Phenelzine Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Benzphetamine + Phenelzine Contraindicated
- Brimonidine + Phenelzine Contraindicated
Frequently asked questions
Can I take Dihydroergotamine intranasal with Phenelzine?
MediHelp rates the interaction as major. Dihydroergotamine intranasal and Phenelzine 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. Combining a non-selective MAOI with dihydroergotamine may raise serotonergic and vasoconstrictive activity. This could lead to serotonin toxicity or marked blood pressure elevation. Ergot vasoconstriction is also a concern in its own right.
How serious is the interaction between Dihydroergotamine intranasal and Phenelzine?
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 and choose another acute migraine therapy while the patient is taking phenelzine. If an ergot is unavoidable, monitor blood pressure and for signs of serotonin toxicity.
What other medicines interact with Phenelzine?
MediHelp also lists interactions of Phenelzine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Phenelzine page.
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