Drug interactions
Ergotamine + Isosorbide mononitrate
Severity: Major
Ergotamine and Isosorbide mononitrate: 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. Ergot derivatives may also reduce the effect of nitrates, and the clinical effect is a loss of antianginal efficacy.
What this interaction means in plain words
Ergotamine and Isosorbide mononitrate 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 mononitrate belongs to Cardiovascular.
Why it happens
Pharmacodynamic antagonism between ergotamine vasoconstriction and nitrate vasodilation.
What to do
Avoid in patients with coronary disease; choose a non-ergot migraine therapy that is safe in ischaemic heart disease 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 mononitrate
- Avanafil + Isosorbide mononitrate Contraindicated
- Isosorbide mononitrate + Riociguat Contraindicated
- Isosorbide mononitrate + Sildenafil Contraindicated
- Isosorbide mononitrate + Tadalafil Contraindicated
- Isosorbide mononitrate + Vardenafil Contraindicated
- Isosorbide mononitrate + 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 mononitrate?
MediHelp rates the interaction as major. Ergotamine and Isosorbide mononitrate 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. Ergot derivatives may also reduce the effect of nitrates, and the clinical effect is a loss of antianginal efficacy.
How serious is the interaction between Ergotamine and Isosorbide mononitrate?
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; choose a non-ergot migraine therapy that is safe in ischaemic heart disease where possible, and monitor for angina and blood pressure rise if unavoidable.
What other medicines interact with Isosorbide mononitrate?
MediHelp also lists interactions of Isosorbide mononitrate with, for example, Avanafil, Riociguat, Sildenafil. The full list is on the Isosorbide mononitrate page.
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