Drug General Information (ID: DDIUIO759V)
Drug Name			Dihydroergotamine		Drug Info		Ephedrine (nasal)		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antimigraine Agents				Cns Stimulants
Structure

Mechanism of Dihydroergotamine-Ephedrine (nasal) Interaction (Severity Level: Major)
Additive hypertensive effects Click to Show/Hide Mechanism Graph
Drug Name		Dihydroergotamine				Ephedrine (nasal)
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 Dihydroergotamine and Ephedrine (nasal)

Recommended Action
Management		Concomitant use of dihydroergotamine with other vasoconstrictive agents is considered contraindicated by the manufacturer. Patients treated with dihydroergotamine 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	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	Product Information. D.H.E. 45 (dihydroergotamine). Sandoz Pharmaceuticals Corporation, East Hanover, NJ.