Methergine and Nefazodone Hydrochloride

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 nefazodone 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). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. 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.

CONTRAINDICATED: Coadministration with nefazodone may significantly increase the plasma concentrations of ergot derivatives. The mechanism involves nefazodone 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 nefazodone, it has occurred in patients receiving ergotamine or dihydroergotamine with other 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. In addition, certain ergot alkaloids such as ergotamine and dihydroergotamine possess serotonergic activity. Coadministration with nefazodone, also a serotonergic agent, may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

MANAGEMENT: Given the potential for ergot toxicity characterized by peripheral vasospasm, ischemia, thrombosis, tachycardia and hypertension, concomitant use of nefazodone with ergot derivatives is considered contraindicated. Concomitant use with ergotamine or dihydroergotamine specifically may be associated with the additional risk of serotonin syndrome.

Methergine

Generic Name: methylergonovine

Brand name: Methergine

Synonyms: Methergine (oral and injection)

What is Methergine?

Nefazodone Hydrochloride

Generic Name: nefazodone

Brand name: Serzone

Synonyms: Nefazodone

What is Nefazodone Hydrochloride?