Conivaptan Hydrochloride 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.

Using methylergonovine together with conivaptan is not recommended. Combining these medications may significantly 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). 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 drug 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 conivaptan may significantly increase the plasma concentrations of ergot derivatives. The mechanism is conivaptan inhibition of CYP450 3A4, the isoenzyme responsible for the metabolic clearance of ergotamine and related drugs. Although the interaction has not been specifically studied with conivaptan, clinical ergotism has occurred in patients receiving ergotamine or dihydroergotamine with other potent 3A4 inhibitors such as macrolide antibiotics and protease inhibitors. Even small, single doses of ergotamine have resulted in clinically significant interactions, occasionally resulting in surgical amputation or death. In pharmacokinetic studies with other drugs that are primarily metabolized by CYP450 3A4 such as midazolam, simvastatin, and amlodipine, conivaptan has increased systemic exposure (AUC) by 2- to 3-fold.

MANAGEMENT: Given the potential for ergot toxicity characterized by peripheral vasospasm, ischemia, thrombosis, tachycardia and hypertension, concomitant use of ergot derivatives with conivaptan should be avoided if possible. Patients currently receiving ergot derivatives should consider an interruption during administration of conivaptan, and allow an appropriate amount of time following completion of conivaptan therapy before resuming these medications.

Conivaptan Hydrochloride

Generic Name: conivaptan

Brand name: Vaprisol

Synonyms: Conivaptan

What is Conivaptan Hydrochloride?

Methergine

Generic Name: methylergonovine

Brand name: Methergine

Synonyms: Methergine (oral and injection)

What is Methergine?