Drug interactions
Ergotamine + Isavuconazonium
Severity: Major
Ergotamine and Isavuconazonium: 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
Isavuconazole, the active moiety, is a moderate CYP3A4 inhibitor and can raise ergotamine concentrations. This increases the risk of ergotism, including severe peripheral ischemia.
What this interaction means in plain words
Ergotamine and Isavuconazonium 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; Isavuconazonium belongs to Anti Fungals.
Why it happens
Isavuconazole inhibits CYP3A4, reducing ergotamine clearance.
What to do
Avoid the combination and use a non-ergot migraine treatment during isavuconazonium therapy. If it is given, monitor closely for ischemic symptoms and use the lowest ergotamine 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?
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References
- CRESEMBA 100 mg hard capsules - SmPC sections 4.3/4.5 (class statement: substrates of CYP3A4/5; "Isavuconazole is a moderate inhibitor of CYP3A4/5; co-administration of isavuconazole with medicinal products which are substrates of CYP3A4/5 may result in inc") — electronic medicines compendium (UK SmPC)
Other interactions of Ergotamine
- Almotriptan + Ergotamine Contraindicated
- Atazanavir + Ergotamine Contraindicated
- Clarithromycin + Ergotamine Contraindicated
- Cobicistat + Ergotamine Contraindicated
- Darunavir + Ergotamine Contraindicated
- Dihydroergotamine intranasal + Ergotamine Contraindicated
Other interactions of Isavuconazonium
- Amobarbital + Isavuconazonium Contraindicated
- Apalutamide + Isavuconazonium Contraindicated
- Carbamazepine + Isavuconazonium Contraindicated
- Cisapride + Isavuconazonium Contraindicated
- Efavirenz + Isavuconazonium Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
Frequently asked questions
Can I take Ergotamine with Isavuconazonium?
MediHelp rates the interaction as major. Ergotamine and Isavuconazonium 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. Isavuconazole, the active moiety, is a moderate CYP3A4 inhibitor and can raise ergotamine concentrations. This increases the risk of ergotism, including severe peripheral ischemia.
How serious is the interaction between Ergotamine and Isavuconazonium?
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 and use a non-ergot migraine treatment during isavuconazonium therapy. If it is given, monitor closely for ischemic symptoms and use the lowest ergotamine dose.
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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