Drug interactions
Ergotamine + Isosorbide dinitrate
Severity: Major
Ergotamine and Isosorbide dinitrate: 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
Ergotamine causes vasoconstriction and can provoke angina or raise blood pressure, opposing the antianginal action of nitrates. Nitrates may also be less effective, and the clinical effect is loss of antianginal efficacy and ischaemia risk.
What this interaction means in plain words
Ergotamine and Isosorbide dinitrate 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; Isosorbide dinitrate belongs to Cardiovascular.
Why it happens
Pharmacodynamic antagonism between ergotamine vasoconstriction and nitrate vasodilation.
What to do
Avoid in patients with coronary disease; use a non-ergot migraine therapy where possible, and monitor for angina and blood pressure rise if unavoidable.
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 Isosorbide dinitrate
- Avanafil + Isosorbide dinitrate Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Isosorbide dinitrate + Sildenafil Contraindicated
- Isosorbide dinitrate + Tadalafil Contraindicated
- Isosorbide dinitrate + Vardenafil Contraindicated
- Isosorbide dinitrate + Methylergonovine Major
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 Isosorbide dinitrate?
MediHelp rates the interaction as major. Ergotamine and Isosorbide dinitrate 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 causes vasoconstriction and can provoke angina or raise blood pressure, opposing the antianginal action of nitrates. Nitrates may also be less effective, and the clinical effect is loss of antianginal efficacy and ischaemia risk.
How serious is the interaction between Ergotamine and Isosorbide dinitrate?
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 in patients with coronary disease; use a non-ergot migraine therapy where possible, and monitor for angina and blood pressure rise if unavoidable.
What other medicines interact with Isosorbide dinitrate?
MediHelp also lists interactions of Isosorbide dinitrate with, for example, Avanafil, Riociguat, Sildenafil. The full list is on the Isosorbide dinitrate page.
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