Interactions médicamenteuses
Dihydroergotamine + Miconazole
Gravité: Majeure
Dihydroergotamine and Miconazole: major interaction.
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Résumé
Dihydroergotamine is cleared mainly by CYP3A4, and strong inhibition of this enzyme can raise ergot levels sharply, causing ergotism with severe peripheral and cerebral vasospasm and ischemia. Miconazole is a CYP3A4 inhibitor and, although vaginal absorption is low, systemic exposure can occur and ergot toxicity is potentially catastrophic.
Ce que signifie cette interaction, en termes simples
Dihydroergotamine and Miconazole 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.
Dihydroergotamine belongs to Central Nervous System; Miconazole belongs to Anti Fungals.
Pourquoi elle survient
Miconazole inhibits CYP3A4-mediated metabolism of dihydroergotamine, increasing its systemic concentrations.
Conduite à tenir
Avoid the combination where possible, and prefer a topical antifungal with minimal absorption or an alternative to the ergot. If used together, counsel the patient to report numbness, cold or painful extremities, or chest pain immediately.
Questions à poser à votre pharmacien
- 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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Autres interactions de Miconazole
- Cabazitaxel + Miconazole Majeure
- Dihydroergotamine intranasal + Miconazole Majeure
- Ergotamine + Miconazole Majeure
- Glyburide + Miconazole Majeure
- Lovastatin + Miconazole Majeure
- Methadone + Miconazole Majeure
Autres interactions de Dihydroergotamine
- Almotriptan + Dihydroergotamine Contre-indiquée
- Clarithromycin + Dihydroergotamine Contre-indiquée
- Dihydroergotamine + Dopamine Contre-indiquée
- Dihydroergotamine + Dronedarone Contre-indiquée
- Dihydroergotamine + Efavirenz Contre-indiquée
- Dihydroergotamine + Eletriptan Contre-indiquée
Questions fréquentes
Can I take Dihydroergotamine with Miconazole?
MediHelp rates the interaction as major. Dihydroergotamine and Miconazole 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. Dihydroergotamine is cleared mainly by CYP3A4, and strong inhibition of this enzyme can raise ergot levels sharply, causing ergotism with severe peripheral and cerebral vasospasm and ischemia. Miconazole is a CYP3A4 inhibitor and, although vaginal absorption is low, systemic exposure can occur and ergot toxicity is potentially catastrophic.
How serious is the interaction between Dihydroergotamine and Miconazole?
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 where possible, and prefer a topical antifungal with minimal absorption or an alternative to the ergot. If used together, counsel the patient to report numbness, cold or painful extremities, or chest pain immediately.
What other medicines interact with Miconazole?
MediHelp also lists interactions of Miconazole with, for example, Cabazitaxel, Dihydroergotamine intranasal, Ergotamine. The full list is on the Miconazole page.
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