Drug interactions
Ergotamine + Levoketoconazole
Severity: Contraindicated
Ergotamine and Levoketoconazole: contraindicated 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
Levoketoconazole is a strong CYP3A4 inhibitor and can markedly increase ergotamine concentrations. This raises the risk of serious ergot toxicity including vasospasm, limb ischemia and cerebral ischemia.
What this interaction means in plain words
Ergotamine and Levoketoconazole are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Ergotamine belongs to Central Nervous System; Levoketoconazole belongs to Endocrine.
Why it happens
Strong inhibition of CYP3A4 reduces first-pass and systemic clearance of ergotamine.
What to do
Avoid the combination; choose a non-ergot acute migraine therapy while on levoketoconazole.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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
Other interactions of Levoketoconazole
- Alfuzosin + Levoketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Amiodarone + Levoketoconazole Contraindicated
- Avanafil + Levoketoconazole Contraindicated
- Cisapride + Levoketoconazole Contraindicated
- Clarithromycin + Levoketoconazole Contraindicated
Frequently asked questions
Can I take Ergotamine with Levoketoconazole?
MediHelp rates the interaction as contraindicated. Ergotamine and Levoketoconazole are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Levoketoconazole is a strong CYP3A4 inhibitor and can markedly increase ergotamine concentrations. This raises the risk of serious ergot toxicity including vasospasm, limb ischemia and cerebral ischemia.
How serious is the interaction between Ergotamine and Levoketoconazole?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; choose a non-ergot acute migraine therapy while on levoketoconazole.
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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