Clotrimazole Lozenge and Methergine

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Clotrimazole may increase the blood levels and effects of methylergonovine, which in some cases can lead to excessive narrowing of blood vessels in the body. This can reduce blood flow to vital organs and increase the risk of rare but serious side effects such as high blood pressure, heart attack, stroke, and gangrene (death of tissues, usually in the arm or leg, that may require surgical amputation). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you experience severe abdominal pain, nausea, vomiting, numbness or tingling, muscle pain or weakness, blue or purple discoloration of fingers or toes, pale or cold skin, chest pain or tightness, irregular heartbeat, severe headache, shortness of breath, blurred vision, confusion, and/or slurred speech during treatment with methylergonovine. Do not take larger doses or use the medication more frequently than prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Coadministration with inhibitors of CYP450 3A4 including azole antifungal agents may increase the plasma concentrations of ergot derivatives, which are primarily metabolized by the isoenzyme. The interaction has occurred in patients receiving ergotamine or dihydroergotamine with potent CYP450 3A4 inhibitors such as macrolide antibiotics and protease inhibitors. Clinical ergotism has been reported, which can lead to gangrene and myocardial infarction in severe cases. Even small, single doses of ergotamine have resulted in clinically significant interactions, occasionally resulting in surgical amputation or death. Within the azole class, itraconazole, ketoconazole, posaconazole and voriconazole are considered potent CYP450 3A4 inhibitors, while fluconazole is comparatively weak and generally causes clinically significant interactions with CYP450 3A4 substrates only at dosages of 200 mg/day or more. It is not known to what extent interactions may occur with clotrimazole troches or miconazole buccal preparations. Although systemic absorption following mucous membrane exposure is limited, the potential for interaction with drugs metabolized by CYP450 3A4 such as ergot alkaloids cannot be ruled out.

MANAGEMENT: Concomitant use of ergot derivatives with fluconazole at high, multiple doses or clotrimazole and miconazole mucous membrane preparations should generally be avoided, if possible. Otherwise, close monitoring for adverse effects such as peripheral vasospasm, ischemia, thrombosis, tachycardia, and hypertension is recommended. Patients should be advised to seek medical attention if they experience potential signs and symptoms of ergotism such as paresthesia, tingling of fingers, cold or painful extremities, numbness, muscle cramps, abdominal pain, rapid pulse, or chest pain.

Clotrimazole Lozenge

Generic Name: clotrimazole

Brand name: Mycelex Troche

Synonyms: Clotrimazole, Clotrimazole (Oral)

What is Clotrimazole Lozenge?

Methergine

Generic Name: methylergonovine

Brand name: Methergine

Synonyms: Methergine (oral and injection)

What is Methergine?