Drug interactions
Ergotamine + Erythromycin base
Severity: Contraindicated
Ergotamine and Erythromycin base: contraindicated interaction.
Last updated Sources: US FDA label
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
Erythromycin markedly raises ergotamine exposure, and this has led to acute ergotism with severe peripheral and cerebral vasospasm and ischemia. Ergotamine labeling contraindicates its use with macrolide antibiotics.
What this interaction means in plain words
Ergotamine and Erythromycin base 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
Erythromycin inhibits CYP3A4-mediated metabolism of ergotamine, increasing its systemic concentrations.
What to do
Do not co-administer; choose a non-interacting antibiotic such as azithromycin if appropriate or an alternative antimigraine therapy. If exposure has occurred, assess for limb ischemia, paresthesias and neurologic symptoms.
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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References
Other interactions of Ergotamine
- Almotriptan + Ergotamine Contraindicated
- Atazanavir + Ergotamine Contraindicated
- Clarithromycin + Ergotamine Contraindicated
- Cobicistat + Ergotamine Contraindicated
- Darunavir + Ergotamine Contraindicated
- Dihydroergotamine intranasal + Ergotamine Contraindicated
Frequently asked questions
Can I take Ergotamine with Erythromycin base?
MediHelp rates the interaction as contraindicated. Ergotamine and Erythromycin base 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. Erythromycin markedly raises ergotamine exposure, and this has led to acute ergotism with severe peripheral and cerebral vasospasm and ischemia. Ergotamine labeling contraindicates its use with macrolide antibiotics.
How serious is the interaction between Ergotamine and Erythromycin base?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer; choose a non-interacting antibiotic such as azithromycin if appropriate or an alternative antimigraine therapy. If exposure has occurred, assess for limb ischemia, paresthesias and neurologic symptoms.
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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