Interações medicamentosas
Dihydroergotamine intranasal + Miconazole
Gravidade: Grave
Dihydroergotamine intranasal and Miconazole: major interaction.
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Resumo
Intranasal dihydroergotamine is still metabolized by CYP3A4, so inhibitors of this enzyme can increase systemic ergot exposure and the risk of vasospastic ischemia. Miconazole can inhibit CYP3A4 after systemic absorption, and ergotism can be severe.
O que esta interação significa em palavras simples
Dihydroergotamine intranasal 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.
Por que acontece
Miconazole inhibits CYP3A4-mediated metabolism of dihydroergotamine, increasing its systemic concentrations.
O que fazer
Avoid the combination where possible and select a non-interacting antifungal or migraine therapy. If unavoidable, monitor for signs of peripheral ischemia such as cold, numb or painful limbs.
O que perguntar ao farmacêutico
- 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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Outras interações de Miconazole
- Cabazitaxel + Miconazole Grave
- Dihydroergotamine + Miconazole Grave
- Ergotamine + Miconazole Grave
- Glyburide + Miconazole Grave
- Lovastatin + Miconazole Grave
- Methadone + Miconazole Grave
Perguntas frequentes
Can I take Dihydroergotamine intranasal with Miconazole?
MediHelp rates the interaction as major. Dihydroergotamine intranasal 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. Intranasal dihydroergotamine is still metabolized by CYP3A4, so inhibitors of this enzyme can increase systemic ergot exposure and the risk of vasospastic ischemia. Miconazole can inhibit CYP3A4 after systemic absorption, and ergotism can be severe.
How serious is the interaction between Dihydroergotamine intranasal 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 select a non-interacting antifungal or migraine therapy. If unavoidable, monitor for signs of peripheral ischemia such as cold, numb or painful limbs.
What other medicines interact with Miconazole?
MediHelp also lists interactions of Miconazole with, for example, Cabazitaxel, Dihydroergotamine, Ergotamine. The full list is on the Miconazole page.
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