Drug interactions
Ergotamine + Methylene blue
Severity: Major
Ergotamine and Methylene blue: 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
Methylene blue inhibits MAO-A and, combined with serotonergic agents, can cause serotonin syndrome. Ergotamine has serotonergic activity, so the theoretical risk is additive, although case evidence with ergots is limited.
What this interaction means in plain words
Ergotamine and Methylene blue 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.
Why it happens
Methylene blue inhibits MAO-A, increasing serotonin, which adds to the serotonergic activity of ergotamine.
What to do
Avoid the combination where possible. If methylene blue is essential, stop ergotamine and monitor for serotonin toxicity, resuming ergotamine only after the recommended washout.
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 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 Methylene blue?
MediHelp rates the interaction as major. Ergotamine and Methylene blue 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. Methylene blue inhibits MAO-A and, combined with serotonergic agents, can cause serotonin syndrome. Ergotamine has serotonergic activity, so the theoretical risk is additive, although case evidence with ergots is limited.
How serious is the interaction between Ergotamine and Methylene blue?
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. If methylene blue is essential, stop ergotamine and monitor for serotonin toxicity, resuming ergotamine only after the recommended washout.
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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