Drug interactions
Ergotamine + Nitroglycerin sublingual
Severity: Major
Ergotamine and Nitroglycerin sublingual: 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's vasoconstriction opposes the vasodilating effect of nitroglycerin, which may reduce its antianginal benefit. In patients with coronary disease, ergot-induced coronary vasospasm may also provoke ischemia.
What this interaction means in plain words
Ergotamine and Nitroglycerin sublingual 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
Pharmacodynamic antagonism between ergotamine vasoconstriction and nitrate-mediated vasodilation; nitrates may also raise ergotamine bioavailability.
What to do
Avoid ergotamine in patients needing nitrates for angina; use an alternative migraine therapy and monitor for chest pain.
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 Nitroglycerin sublingual?
MediHelp rates the interaction as major. Ergotamine and Nitroglycerin sublingual 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's vasoconstriction opposes the vasodilating effect of nitroglycerin, which may reduce its antianginal benefit. In patients with coronary disease, ergot-induced coronary vasospasm may also provoke ischemia.
How serious is the interaction between Ergotamine and Nitroglycerin sublingual?
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 ergotamine in patients needing nitrates for angina; use an alternative migraine therapy and monitor for chest pain.
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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