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Drug Interaction Report

1 drug interaction and 6 additional warnings found for the following 2 drugs:

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Drug interactions

Minor drug interactions

Minor:

methylergonovine menthol topical

Applies to: methylergonovine, Bioaches patch (capsaicin / menthol topical)

Coadministration with orally administered menthol may decrease plasma concentrations of drugs that are substrates of the CYP450 3A4 and/or CYP450 2C9 isoenzymes. The proposed mechanism is increased clearance due to menthol-mediated induction of CYP450 3A4 and CYP450 2C9. In vivo data suggests that concomitant administration of oral menthol reduced the systemic exposure (AUC) of triazolam (a CYP450 3A4 substrate) by 40%, and phenytoin (a CYP450 2C9 substrate) by 20%. Until further data are available, no specific precautions are recommended.

The information above is from our professional interaction data. Consumer information is not available for this interaction.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

Food/Lifestyle methylergonovine

Applies to: methylergonovine

Grapefruit juice may increase the blood levels of certain medications such as methylergonovine.

You may want to limit your consumption of grapefruit and grapefruit juice during treatment with methylergonovine. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication.

Contact your doctor if your condition changes or you experience increased side effects.

Orange juice is not expected to interact.

Disease interactions

5 potential interactionsApplies to: 5 conditions, including High Blood Pressure, Liver Disease, Cardiovascular Conditions and Disorders, Renal Dysfunction, and Arteriovenous Shunting.

Arteriovenous Shunting

Major:

methylergonovine

Methylergonovine has a major potential interaction with Arteriovenous Shunting.

The amine ergot alkaloids, ergonovine and methylergonovine, can cause serious cardiovascular complications because of their vasospastic effects. Hypertension (more often with ergonovine) has been most commonly reported, particularly when administered IV undiluted or at an excessive rate or when used in conjunction with regional anesthesia or vasoconstrictors. Headaches, seizures, cerebrovascular accidents and death have been associated with the hypertensive episodes. Other, less common adverse effects include acute myocardial infarction, transient chest pains, thrombophlebitis, tachycardia and palpitations. Therapy with ergot alkaloids should generally be avoided, except under special circumstances, in patients with chronic hypertension, preeclampsia or eclampsia, cardiovascular disease, cerebrovascular disease, or peripheral vascular disease. Caution is advised when these agents are administered to patients with venoatrial shunts, mitral valve stenosis, or sepsis. Close monitoring of cardiovascular status is highly recommended during therapy.

Cardiovascular Conditions and Disorders

Major:

methylergonovine

Methylergonovine has a major potential interaction with Cardiovascular Conditions and Disorders.

The amine ergot alkaloids, ergonovine and methylergonovine, can cause serious cardiovascular complications because of their vasospastic effects. Hypertension (more often with ergonovine) has been most commonly reported, particularly when administered IV undiluted or at an excessive rate or when used in conjunction with regional anesthesia or vasoconstrictors. Headaches, seizures, cerebrovascular accidents and death have been associated with the hypertensive episodes. Other, less common adverse effects include acute myocardial infarction, transient chest pains, thrombophlebitis, tachycardia and palpitations. Therapy with ergot alkaloids should generally be avoided, except under special circumstances, in patients with chronic hypertension, preeclampsia or eclampsia, cardiovascular disease, cerebrovascular disease, or peripheral vascular disease. Caution is advised when these agents are administered to patients with venoatrial shunts, mitral valve stenosis, or sepsis. Close monitoring of cardiovascular status is highly recommended during therapy.

High Blood Pressure

Major:

methylergonovine

Methylergonovine has a major potential interaction with High Blood Pressure.

The use of the amine ergot alkaloids, ergonovine and methylergonovine, is considered by some clinicians to be contraindicated in patients with hypertension. These agents can cause hypertension, particularly when administered IV undiluted or at an excessive rate or when used in conjunction with regional anesthesia or vasoconstrictors. Headaches, seizures, cerebrovascular accidents and death have been associated with the hypertensive episodes. Patients with chronic hypertension or preeclampsia may be at increased risk for these complications. Of the two agents, methylergonovine has less tendency to cause hypertension, although preferably neither agent should be administered to at- risk patients.

Liver Disease

Moderate:

methylergonovine

Methylergonovine has a moderate potential interaction with Liver Disease.

The amine ergot alkaloids, ergonovine and methylergonovine, appear to be eliminated by both renal and hepatic routes. Patients with renal and/or liver disease may be at greater risk for adverse effects from these agents due to decreased drug clearance. Caution is advised if these agents are used. Dosage adjustments may be necessary.

Renal Dysfunction

Moderate:

methylergonovine

Methylergonovine has a moderate potential interaction with Renal Dysfunction.

The amine ergot alkaloids, ergonovine and methylergonovine, appear to be eliminated by both renal and hepatic routes. Patients with renal and/or liver disease may be at greater risk for adverse effects from these agents due to decreased drug clearance. Caution is advised if these agents are used. Dosage adjustments may be necessary.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.