Drug interactions
Ergoloid mesylates + Ketoconazole
Severity: Major
Ergoloid mesylates and Ketoconazole: 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
Ketoconazole may raise ergoloid concentrations. Although ergoloids are less vasoconstrictive than other ergots, the interaction with potent CYP3A4 inhibitors is regarded as potentially dangerous.
What this interaction means in plain words
Ergoloid mesylates and Ketoconazole 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
Inhibition of CYP3A4 by ketoconazole is predicted to reduce ergoloid metabolism.
What to do
Avoid the combination where possible. If both are needed, monitor for nausea, vasospasm and ischemic symptoms and consider reducing the ergoloid dose.
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 Ergoloid mesylates and Ketoconazole, 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
- Ketoconazole Esteve 200 mg Tablets - SmPC sections 4.3/4.5 (class statement: ergot alkaloids; "ergot alkaloids (eg dihydroergotamine, ergometrine (ergonovine), ergotamine and methylergometrine (methylergonovine) due to an increased risk of ergotism and ot") — electronic medicines compendium (UK SmPC)
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Ergoloid mesylates with Ketoconazole?
MediHelp rates the interaction as major. Ergoloid mesylates and Ketoconazole 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. Ketoconazole may raise ergoloid concentrations. Although ergoloids are less vasoconstrictive than other ergots, the interaction with potent CYP3A4 inhibitors is regarded as potentially dangerous.
How serious is the interaction between Ergoloid mesylates and Ketoconazole?
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. If both are needed, monitor for nausea, vasospasm and ischemic symptoms and consider reducing the ergoloid dose.
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.
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.
