Drug interactions
Ergotamine + Nirmatrelvir
Severity: Contraindicated
Ergotamine and Nirmatrelvir: contraindicated interaction.
Last updated Sources: US FDA label
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
Nirmatrelvir is given with ritonavir, which strongly inhibits CYP3A, so ergotamine exposure can rise sharply. This may cause acute ergot toxicity with peripheral and cerebral vasospasm and ischemia.
What this interaction means in plain words
Ergotamine and Nirmatrelvir 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; Nirmatrelvir belongs to Anti Virals.
Why it happens
Ritonavir-boosted nirmatrelvir strongly inhibits CYP3A4, blocking ergotamine metabolism.
What to do
Do not use together; withhold ergotamine during the treatment course and for several days after, and use a non-ergot migraine option.
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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References
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 Nirmatrelvir
- Alfuzosin + Nirmatrelvir Contraindicated
- Amiodarone + Nirmatrelvir Contraindicated
- Apalutamide + Nirmatrelvir Contraindicated
- Carbamazepine + Nirmatrelvir Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
- Dronedarone + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Ergotamine with Nirmatrelvir?
MediHelp rates the interaction as contraindicated. Ergotamine and Nirmatrelvir 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. Nirmatrelvir is given with ritonavir, which strongly inhibits CYP3A, so ergotamine exposure can rise sharply. This may cause acute ergot toxicity with peripheral and cerebral vasospasm and ischemia.
How serious is the interaction between Ergotamine and Nirmatrelvir?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together; withhold ergotamine during the treatment course and for several days after, and use a non-ergot migraine option.
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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