Drug interactions
Dihydroergotamine intranasal + Pseudoephedrine
Severity: Major
Dihydroergotamine intranasal and Pseudoephedrine: 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
Pseudoephedrine and dihydroergotamine both constrict blood vessels, so combined use can produce hypertension and ischemia. Intranasal dihydroergotamine is systemically absorbed, so the risk is real.
What this interaction means in plain words
Dihydroergotamine intranasal and Pseudoephedrine 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 vasoconstriction from indirect sympathomimetic action and ergot-mediated vascular receptor agonism.
What to do
Avoid combining; use a non-vasoconstricting option for nasal congestion. Monitor blood pressure and for limb or cerebral ischemia if unavoidable.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Dihydroergotamine intranasal and Pseudoephedrine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
- Boots Decongestant Tablets - SmPC sections 4.3/4.5 (class statement: Ergot alkaloids; "Ergot alkaloids (ergotamine & methysergide): increased risk of ergotism.") — electronic medicines compendium (UK SmPC)
Other interactions of Pseudoephedrine
- Isocarboxazid + Pseudoephedrine Contraindicated
- Phenelzine + Pseudoephedrine Contraindicated
- Pseudoephedrine + Rasagiline Contraindicated
- Pseudoephedrine + Selegiline Contraindicated
- Pseudoephedrine + Selegiline transdermal Contraindicated
- Pseudoephedrine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Dihydroergotamine intranasal with Pseudoephedrine?
MediHelp rates the interaction as major. Dihydroergotamine intranasal and Pseudoephedrine 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. Pseudoephedrine and dihydroergotamine both constrict blood vessels, so combined use can produce hypertension and ischemia. Intranasal dihydroergotamine is systemically absorbed, so the risk is real.
How serious is the interaction between Dihydroergotamine intranasal and Pseudoephedrine?
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 combining; use a non-vasoconstricting option for nasal congestion. Monitor blood pressure and for limb or cerebral ischemia if unavoidable.
What other medicines interact with Pseudoephedrine?
MediHelp also lists interactions of Pseudoephedrine with, for example, Isocarboxazid, Phenelzine, Rasagiline. The full list is on the Pseudoephedrine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
