Drug interactions
Ergotamine + Erythromycin
Severity: Contraindicated
Ergotamine and Erythromycin: contraindicated 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
Erythromycin markedly increases ergotamine exposure and can trigger acute ergotism, with severe peripheral vasoconstriction, ischemia of the limbs, and cerebral ischemia. Cases of gangrene have been reported with macrolide and ergot combinations.
What this interaction means in plain words
Ergotamine and Erythromycin 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.
Ergotamine belongs to Central Nervous System; Erythromycin belongs to Anti Bacterial.
Why it happens
Inhibition of CYP3A4 decreases ergotamine metabolism, causing excessive vasoconstrictor exposure.
What to do
Avoid the combination; choose a non-macrolide antibiotic or a non-ergot migraine treatment such as a triptan after checking labeling. Stop ergotamine and seek urgent care if numbness, coldness, or ischemic symptoms appear.
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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Other interactions of Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
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?
MediHelp rates the interaction as contraindicated. Ergotamine and Erythromycin 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 increases ergotamine exposure and can trigger acute ergotism, with severe peripheral vasoconstriction, ischemia of the limbs, and cerebral ischemia. Cases of gangrene have been reported with macrolide and ergot combinations.
How serious is the interaction between Ergotamine and Erythromycin?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; choose a non-macrolide antibiotic or a non-ergot migraine treatment such as a triptan after checking labeling. Stop ergotamine and seek urgent care if numbness, coldness, or ischemic symptoms appear.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
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