Migranal (dihydroergotamine) and Alcohol / Food Interactions
There are 3 alcohol/food/lifestyle interactions with Migranal (dihydroergotamine) which include:
dihydroergotamine ↔ Nicotine
Moderate Drug Interaction
Nicotine may increase the effects of dihydroergotamine in narrowing the blood vessels and decreasing blood flow. A severe decrease in blood flow to the brain and other parts of the body can lead to dangerous side effects. Contact your doctor immediately if you experience coldness, paleness, discoloration, numbness, tingling, or pain in your hands or feet; muscle pain or weakness; severe or worsening headache; blurred vision; severe abdominal pain; chest pain; or shortness of breath while taking these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
dihydroergotamine ↔ food
Moderate Food Interaction
Consumer information for this interaction is not currently available.
MONITOR: Grapefruit juice may increase the plasma concentrations of orally administered drugs that are substrates of the CYP450 3A4 isoenzyme. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Because grapefruit juice inhibits primarily intestinal rather than hepatic CYP450 3A4, the magnitude of interaction is greatest for those drugs that undergo significant presystemic metabolism by CYP450 3A4 (i.e., drugs with low oral bioavailability). In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Pharmacokinetic interactions involving grapefruit juice are also subject to a high degree of interpatient variability, thus the extent to which a given patient may be affected is difficult to predict.
MANAGEMENT: Patients who regularly consume grapefruit or grapefruit juice should be monitored for adverse effects and altered plasma concentrations of drugs that undergo significant presystemic metabolism by CYP450 3A4. Grapefruit and grapefruit juice should be avoided if an interaction is suspected. Orange juice is not expected to interact with these drugs.
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High Blood Pressure (Hypertension)
Severe Potential Hazard, High plausibility
ergot alkaloids - vasospastic reactions
The use of ergot alkaloids is contraindicated in patients with conditions predisposing them to vasospastic reactions, including, ischemic heart disease (angina, history of myocardial infarction, silent ischemia), peripheral vascular disease, sepsis, shock, vascular surgery, uncontrolled hypertension, and severely impaired hepatic or renal function. The vasoconstriction produced be ergot alkaloids may exacerbate these conditions. Nitroprusside and heparin have been used to treat ergotamine- induced severe vasoconstriction.
- "Product Information. Migranal (dihydroergotamine nasal)." Novartis Pharmaceuticals, East Hanover, NJ.
- "Product Information. D.H.E. 45 (dihydroergotamine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
Migranal (dihydroergotamine) drug interactions
There are 641 drug interactions with Migranal (dihydroergotamine)
Migranal (dihydroergotamine) disease interactions
There is 1 disease interaction with Migranal (dihydroergotamine):
More about Migranal (dihydroergotamine)
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- Drug class: antimigraine agents
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Drug Interaction Classification
|Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
|No information available.|
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