Drug interactions
Ergotamine + Voxelotor
Severity: Major
Ergotamine and Voxelotor: 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
Voxelotor inhibits CYP3A4 and may increase exposure to sensitive CYP3A4 substrates. Because ergotamine has a narrow therapeutic margin, higher levels could lead to vasospasm and ischemia.
What this interaction means in plain words
Ergotamine and Voxelotor 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; Voxelotor belongs to Miscellaneous.
Why it happens
Voxelotor inhibits CYP3A4, decreasing ergotamine metabolism.
What to do
Avoid the combination and use an alternative migraine treatment that does not rely on CYP3A4 clearance. If coadministration is unavoidable, use the lowest ergotamine dose and monitor for peripheral ischemia.
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
Other interactions of Voxelotor
- Amobarbital + Voxelotor Major
- Apalutamide + Voxelotor Major
- Carbamazepine + Voxelotor Major
- Cyclosporin + Voxelotor Major
- Efavirenz + Voxelotor Major
- Enzalutamide + Voxelotor Major
Frequently asked questions
Can I take Ergotamine with Voxelotor?
MediHelp rates the interaction as major. Ergotamine and Voxelotor 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. Voxelotor inhibits CYP3A4 and may increase exposure to sensitive CYP3A4 substrates. Because ergotamine has a narrow therapeutic margin, higher levels could lead to vasospasm and ischemia.
How serious is the interaction between Ergotamine and Voxelotor?
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 and use an alternative migraine treatment that does not rely on CYP3A4 clearance. If coadministration is unavoidable, use the lowest ergotamine dose and monitor for peripheral ischemia.
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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