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Methylergonovine Maleate Injection and Timoptic-XE

Determining the interaction of Methylergonovine Maleate Injection and Timoptic-XE and the possibility of their joint administration.

Check result:
Methylergonovine Maleate Injection <> Timoptic-XE
Relevance: 13.08.2022 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Timolol ophthalmic may increase the effects of methylergonovine in narrowing the blood vessels and decreasing blood flow. A severe decrease in blood flow to the brain and other parts of the body can lead to dangerous side effects. Contact your doctor immediately if you experience coldness, paleness, discoloration, numbness, tingling, or pain in your hands or feet; muscle pain or weakness; severe or worsening headache; blurred vision; severe abdominal pain; chest pain; or shortness of breath while taking these medications. 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.

Professional:

MONITOR: Several case reports have suggested that beta-blockers may potentiate the vasoconstrictive action of ergot alkaloids. The exact mechanism of interaction is unknown, but may involve blockade of beta-2-mediated (i.e., sympathetic) vasodilatation. In addition, beta-1 blockade reduces cardiac output, which can diminish blood flow and exacerbate ergot-induced vasospasm. Peripheral ischemia, hypertension with chest pain, gangrene resulting in surgical amputation, and migraine exacerbation have been described in suspected cases of the interaction. Reported cases have involved the noncardioselective beta-blockers, propranolol and oxprenolol. However, a theoretical risk also exists with cardioselective beta-blockers, since beta-1 selectivity is not absolute and may be lost with larger doses. The interaction may also occur with beta-blocker ophthalmic preparations, since they may be systemically absorbed and can produce clinically significant systemic effects even at low or undetectable plasma levels. In any case, the interaction appears to be rare, and patients have taken both drugs without adverse effects.

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
  • "Product Information. Migranal (dihydroergotamine nasal)." Novartis Pharmaceuticals, East Hanover, NJ.
  • Baumrucker JF "Drug interaction: propranolol and cafergot." N Engl J Med 288 (1973): 916-7
  • "Product Information. Cafergot (caffeine-ergotamine)." Novartis Pharmaceuticals, East Hanover, NJ.
  • Gandy W "Dihydroergotamine interaction with propranolol ." Ann Emerg Med 19 (1990): 221
  • Blank NK, Rieder MJ "Paradoxical response to propranolol in migraine." Lancet 2 (1973): 1336
  • 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
Methylergonovine Maleate Injection

Generic Name: methylergonovine

Brand name: Methergine

Synonyms: Methylergonovine (oral and injection), Methylergonovine

Timoptic-XE

Generic Name: timolol ophthalmic

Brand name: Betimol, Istalol, Timoptic Ocudose, Timoptic Ocumeter, Timoptic Ocumeter Plus, Timoptic-XE, Timoptic

Synonyms: Timoptic XE

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle