Drug interactions
Ergotamine + Fexinidazole
Severity: Major
Ergotamine and Fexinidazole: 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
Fexinidazole inhibits CYP3A4 and may raise ergotamine concentrations, increasing the risk of ergotism with vasospasm and ischemia. Because ergotamine has a narrow margin of safety with CYP3A4 inhibitors, the combination is best avoided.
What this interaction means in plain words
Ergotamine and Fexinidazole 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
Fexinidazole inhibits CYP3A4, reducing the metabolic clearance of ergotamine.
What to do
Avoid concurrent use; hold ergotamine during the fexinidazole course. If unavoidable, monitor for paresthesias, cold extremities and ischemic symptoms.
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
Frequently asked questions
Can I take Ergotamine with Fexinidazole?
MediHelp rates the interaction as major. Ergotamine and Fexinidazole 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. Fexinidazole inhibits CYP3A4 and may raise ergotamine concentrations, increasing the risk of ergotism with vasospasm and ischemia. Because ergotamine has a narrow margin of safety with CYP3A4 inhibitors, the combination is best avoided.
How serious is the interaction between Ergotamine and Fexinidazole?
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 concurrent use; hold ergotamine during the fexinidazole course. If unavoidable, monitor for paresthesias, cold extremities and ischemic 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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