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Drug interactions

Methylergonovine + Mifepristone

Severity: Major

Methylergonovine and Mifepristone: 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

Mifepristone inhibits CYP3A4, which metabolizes methylergonovine. Higher ergot levels can cause severe vasospasm with peripheral or cerebral ischemia.

What this interaction means in plain words

Methylergonovine and Mifepristone 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.

Evidence level: Moderate

Why it happens

CYP3A4 inhibition by mifepristone reduces methylergonovine clearance.

What to do

Avoid concurrent use with chronic mifepristone therapy and choose another uterotonic such as oxytocin if needed. If given, monitor for 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Methylergonovine with Mifepristone?

MediHelp rates the interaction as major. Methylergonovine and Mifepristone 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. Mifepristone inhibits CYP3A4, which metabolizes methylergonovine. Higher ergot levels can cause severe vasospasm with peripheral or cerebral ischemia.

How serious is the interaction between Methylergonovine and Mifepristone?

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 concurrent use with chronic mifepristone therapy and choose another uterotonic such as oxytocin if needed. If given, monitor for ischemic symptoms.

What other medicines interact with Mifepristone?

MediHelp also lists interactions of Mifepristone with, for example, Apixaban, Argatroban, Cisapride. The full list is on the Mifepristone page.

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