Drug interactions
Ergotamine + Milnacipran
Severity: Moderate
Ergotamine and Milnacipran: moderate 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 has serotonergic activity, and combined with milnacipran there is potential for serotonin syndrome as well as additive vasoconstriction and blood pressure elevation. Documented evidence for this pair is limited.
What this interaction means in plain words
Ergotamine and Milnacipran can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Ergotamine belongs to Central Nervous System; Milnacipran belongs to Central Nervous System.
Why it happens
Additive serotonergic activity and vasoconstrictor or pressor effects.
What to do
Monitor for serotonin syndrome symptoms, hypertension and signs of peripheral ischemia such as cold or numb extremities. Prefer an alternative migraine therapy if the patient has vascular disease.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide Contraindicated
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 Milnacipran?
MediHelp rates the interaction as moderate. Ergotamine and Milnacipran can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ergotamine has serotonergic activity, and combined with milnacipran there is potential for serotonin syndrome as well as additive vasoconstriction and blood pressure elevation. Documented evidence for this pair is limited.
How serious is the interaction between Ergotamine and Milnacipran?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for serotonin syndrome symptoms, hypertension and signs of peripheral ischemia such as cold or numb extremities. Prefer an alternative migraine therapy if the patient has vascular disease.
What other medicines interact with Milnacipran?
MediHelp also lists interactions of Milnacipran with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Milnacipran page.
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