Drug interactions
Elranatamab + Ergotamine
Severity: Major
Elranatamab and Ergotamine: 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
Elranatamab can trigger cytokine release syndrome, and the resulting inflammatory state may temporarily reduce CYP3A4 activity. Ergotamine is a CYP3A4 substrate, so its exposure may rise and the risk of ergotism, with peripheral vasospasm and ischemia, increases.
What this interaction means in plain words
Elranatamab and Ergotamine 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.
Elranatamab belongs to Oncology; Ergotamine belongs to Central Nervous System.
Why it happens
Cytokine-mediated suppression of CYP3A4 reduces ergotamine clearance during and after cytokine release syndrome.
What to do
Avoid starting ergotamine during step-up dosing and for about 14 days after the first treatment dose, and during any CRS episode. If it cannot be avoided, monitor for signs of ergotism such as cold, numb or painful extremities, nausea and paresthesia.
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 Ergotamine
- Almotriptan + Ergotamine Contraindicated
- Atazanavir + Ergotamine Contraindicated
- Clarithromycin + Ergotamine Contraindicated
- Cobicistat + Ergotamine Contraindicated
- Darunavir + Ergotamine Contraindicated
- Dihydroergotamine intranasal + Ergotamine Contraindicated
Other interactions of Elranatamab
- Elranatamab + Pimozide Major
- Bendamustine + Elranatamab Moderate
- Carbamazepine + Elranatamab Moderate
- Clomipramine + Elranatamab Moderate
- Clozapine + Elranatamab Moderate
- Colchicine + Elranatamab Moderate
Frequently asked questions
Can I take Elranatamab with Ergotamine?
MediHelp rates the interaction as major. Elranatamab and Ergotamine 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. Elranatamab can trigger cytokine release syndrome, and the resulting inflammatory state may temporarily reduce CYP3A4 activity. Ergotamine is a CYP3A4 substrate, so its exposure may rise and the risk of ergotism, with peripheral vasospasm and ischemia, increases.
How serious is the interaction between Elranatamab and Ergotamine?
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 starting ergotamine during step-up dosing and for about 14 days after the first treatment dose, and during any CRS episode. If it cannot be avoided, monitor for signs of ergotism such as cold, numb or painful extremities, nausea and paresthesia.
What other medicines interact with Ergotamine?
MediHelp also lists interactions of Ergotamine with, for example, Almotriptan, Atazanavir, Clarithromycin. The full list is on the Ergotamine page.
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