Drug General Information (ID: DDI8PG3QDN)
Drug Name			Phenylpropanolamine		Drug Info		Ergotamine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Appetite Depressants				Analgesics
Structure

Mechanism of Phenylpropanolamine-Ergotamine Interaction (Severity Level: Major)
Additive hypertensive effects Click to Show/Hide Mechanism Graph
Drug Name		Phenylpropanolamine				Ergotamine
Mechanism		Hypertensive effects				Hypertensive effects
Key Mechanism Factor 1
		Factor Name		Hypertensive effects
		Factor Description		Hypertension is defined as a blood pressure reading above a prescribed limit (130/90 mmHg). Most people with hypertension have no signs or symptoms; others may experience: severe headache, shortness of breath, nosebleeds, severe anxiety, and feeling a tingling sensation in the neck or head.
Mechanism Description		Additive hypertensive effects by the combination of Phenylpropanolamine and Ergotamine

Recommended Action
Management		Ergot alkaloids should generally not be administered in combination with other vasoconstrictive agents. If concomitant use is required, patients should be monitored for excessive vasoconstriction and have vital signs measured regularly. Patients should also be advised to seek immediate medical attention if they experience potential symptoms of ischemia such as coldness, pallor, cyanosis, numbness, tingling, or pain in the extremities muscle weakness severe or worsening headache visual disturbances severe abdominal pain chest pain and shortness of breath.

References
1	Barthel W, Glusa E, Koth W "Interactions of dihydroergotamine with etilefrine in human leg veins in vitro and in situ." Int J Clin Pharmacol Ther Toxicol 25 (1987): 63-9. [PMID: 2881898]
2	Buchanan N, Cane RD, Miller M "Symmetrical gangrene of the extremities associated with the use of dopamine subsequent to ergometrine administration." Intensive Care Med 3 (1977): 55-6. [PMID: 561121]
3	Chuang SS "Finger ischemia secondary to the synergistic agonist effect of norepinephrine and ergonovine and in a burn patient." Burns 29 (2003): 92-4. [PMID: 12543053]
4	Product Information. Bellergal-S (ergotamine). Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
5	Product Information. D.H.E. 45 (dihydroergotamine). Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
6	Product Information. ProAmatine (midodrine). Roberts Pharmaceutical Corporation, Eatontown, NJ.