Adrenaline
Adverse Effect: Extreme elevation of blood pressure Clinical Management: The concurrent use of dihydroergotamine with Adrenaline is contraindicated.
Clarithromycin
Adverse Effect: Acute ergotism (nausea, vomiting, vasospastic ischemia) Clinical Management: Concomitant use is not recommended. However, patients receiving dihydroergotamine and clarithromycin should be monitored for increased ergot toxicity (nausea, vomiting, vasospastic ischemia).
Propranolol
Adverse Effect: Peripheral ischemia or a hypertensive episode Clinical Management: If used together, monitor for peripheral ischemic effects (eg, cold extremities), and choose a selective beta blocker (eg, atenolol) if ischemia occurs. Also monitor blood pressure carefully.
Sumatriptan
Adverse Effect: Prolonged vasospastic reactions Clinical Management: Use of sumatriptan within 24 hours of an ergot preparation, such as dihydroergotamine, is contraindicated. |