Drug interactions
Ergotamine + Palbociclib
Severity: Major
Ergotamine and Palbociclib: major 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
Palbociclib is a weak time-dependent CYP3A4 inhibitor and may raise ergotamine concentrations. Ergotamine toxicity (ergotism) causes severe peripheral and cerebral vasospasm and ischemia, so even modest increases matter given its narrow therapeutic index.
What this interaction means in plain words
Ergotamine and Palbociclib 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 belongs to Central Nervous System; Palbociclib belongs to Oncology.
Why it happens
Palbociclib inhibits CYP3A4, reducing the metabolism of ergotamine.
What to do
Avoid the combination if possible and choose a non-ergot migraine therapy. If unavoidable, use the lowest ergotamine dose and monitor for numbness, tingling, cold extremities and ischemic symptoms.
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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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 Palbociclib
Frequently asked questions
Can I take Ergotamine with Palbociclib?
MediHelp rates the interaction as major. Ergotamine and Palbociclib 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. Palbociclib is a weak time-dependent CYP3A4 inhibitor and may raise ergotamine concentrations. Ergotamine toxicity (ergotism) causes severe peripheral and cerebral vasospasm and ischemia, so even modest increases matter given its narrow therapeutic index.
How serious is the interaction between Ergotamine and Palbociclib?
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 if possible and choose a non-ergot migraine therapy. If unavoidable, use the lowest ergotamine dose and monitor for numbness, tingling, cold extremities and ischemic symptoms.
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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