Clarithromycin and Ergotamine: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Clarithromycin and Ergotamine unless specifically directed by your doctor.
How Clarithromycin interacts with Ergotamine
Strong CYP3A4 inhibition by clarithromycin elevates ergotamine levels causing intense vasoconstriction (ergotism) with peripheral ischaemia and rare gangrene.
What you should do
Contraindicated; use azithromycin or doxycycline for infection in migraine patients on ergot derivatives, and counsel patients to seek urgent care if cold or painful extremities develop.
Key facts
Severity
Major — avoid combination
Mechanism
Strong CYP3A4 inhibition by clarithromycin elevates ergotamine levels causing intense vasoconstriction (ergotism) with p...
Action
Contraindicated; use azithromycin or doxycycline for infection in migraine patients on ergot derivatives, and counsel pa...
Frequently asked questions
Can I take Clarithromycin and Ergotamine together?
No — this combination should generally be avoided. Contraindicated; use azithromycin or doxycycline for infection in migraine patients on ergot derivatives, and counsel patients to seek urgent care if cold or painful extremities develop.
What is the severity of this interaction?
The interaction between Clarithromycin and Ergotamine is classified as Major — avoid combination. Strong CYP3A4 inhibition by clarithromycin elevates ergotamine levels causing intense vasoconstriction (ergotism) with peripheral ischaemia and rare gangrene.
What should I do if I'm prescribed both?
Contraindicated; use azithromycin or doxycycline for infection in migraine patients on ergot derivatives, and counsel patients to seek urgent care if cold or painful extremities develop. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.