Drug General Information (ID: DDILHR5Q4J)
Drug Name			Methysergide		Drug Info		Levobunolol (ophthalmic)		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vasoconstrictor Agents				Sympatholytics
Structure

Mechanism of Methysergide-Levobunolol (ophthalmic) Interaction (Severity Level: Moderate)
Additive hypertensive effects Click to Show/Hide Mechanism Graph
Drug Name		Methysergide				Levobunolol (ophthalmic)
Mechanism		Ergot alkaloid				Potentiate the vasoconstrictive action of ergot alkaloid
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 Methysergide and Levobunolol (ophthalmic)

Recommended Action
Management		Except for increased awareness of the interaction, no specific intervention appears to be necessary. Patients should 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	Product Information. Cafergot (caffeine-ergotamine). Novartis Pharmaceuticals, East Hanover, NJ.
2	Product Information. Migranal (dihydroergotamine nasal). Novartis Pharmaceuticals, East Hanover, NJ.
3	Venter CP, Joubert PH, Buys AC "Severe peripheral ischaemia during concomitant use of beta blockers and ergot alkaloids." Br Med J 289 (1984): 288-9