Drug interactions
Ergotamine + Fluoxetine
Severity: Major
Ergotamine and Fluoxetine: 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
Fluoxetine with ergotamine may cause serotonin syndrome, and fluoxetine may also raise ergotamine exposure, increasing the risk of vasospasm and ischemia. Peripheral ischemia has been reported with ergot derivatives and serotonergic drugs.
What this interaction means in plain words
Ergotamine and Fluoxetine 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.
Ergotamine belongs to Central Nervous System; Fluoxetine belongs to Central Nervous System.
Why it happens
Additive serotonergic activity, plus possible CYP3A4 inhibition by fluoxetine and its metabolite reducing ergotamine clearance.
What to do
Avoid the combination where possible and choose another migraine therapy; if used, watch for serotonin toxicity and signs of ischemia such as cold, painful or numb extremities.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline 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 Fluoxetine?
MediHelp rates the interaction as major. Ergotamine and Fluoxetine 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. Fluoxetine with ergotamine may cause serotonin syndrome, and fluoxetine may also raise ergotamine exposure, increasing the risk of vasospasm and ischemia. Peripheral ischemia has been reported with ergot derivatives and serotonergic drugs.
How serious is the interaction between Ergotamine and Fluoxetine?
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 and choose another migraine therapy; if used, watch for serotonin toxicity and signs of ischemia such as cold, painful or numb extremities.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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