Peripheral Ischemia Following Coadministration With Strong CYP3A4 Iinhibitors
Serious and/or life threatening peripheral ischemia has been reported with coadministration of this drug with potent CYP 3A4 inhibitors (including protease inhibitors and macrolide antibiotics).
Because CYP3A4 inhibition elevates the serum levels of ergotamine and dihyergotamine, the risk of vasospasm leading to cerebral ischemia and/or ischemia of the extremities is increased.