Ergot derivatives and

Horowski, R., and Wachtel, H. (1979) Pharmacological effects of lisuride in rodents Mechanism of action and influence of chronic treatments with lisuride. In Dopaminergic Ergot Derivates and Motor Function, edited by K. Fuxe and D. B. Caine, pp. 237-251. Pergamon Press, New York. 

Ergot derivatives and triptans are specific treatments for migraine. Both are 5HTib/id serotonergic agonists. 

All four exert similar therapeutic effects and can produce the same adverse effects seen with levodopa. The differences between the ergot derivatives and the... 

Drug treatments include analgesics such as aspirin, opioids, ergot derivatives and triptans (5-HTi agonists). 

BETA-BLOCKERS ERGOT DERIVATIVES Three reported cases of arterial vasoconstriction and one of T BP occurred when ergotamine or methysergide was added to propanolol or oxprenolol Ergotamine can cause peripheral vasospasm, and absence of beta-adrenergic activity can t the risk of vasoconstriction Ergot derivatives and beta-blockers are often co-administered without trouble however, monitor BP at least weekly until stable (watch for t BP) and warn patients to stop the ergot derivative and seek medical attention if they develop cold, painful feet... 

ERGOTAMINE, METHYSERGIDE 5-HT1 AGONISTS-TRIPTANS T risk of vasospasm Additive effect 1. Do not administer ergotamine and almotriptan, rizatriptan, sumatriptan or zolmitriptan within 6 hours of each other 2. Do not administer methy-sergide and almotriptan, rizatriptan, sumatriptan or zolmitriptan within 24 hours of each other 3. Do not administer an ergot derivative and eletriptan orfrovatriptan within 24 hours of each other... 

Most of the dopamine receptor agonists in current use are ergot derivatives, and these are known to cause serosal fibroinflammatory syndromes. 

The drugs dealt with in this section are the ergot derivatives and the triptans (or more properly the serotonin 5-HTj agonists), whose main use is in the treatment of migraine. Table 16.1 , (below) lists some of the drugs commonly used in migraine. Drugs such as propranolol, which are more commonly used in other conditions, are discussed elsewhere in the publication. 

Information is very limited indeed. The incidence and general importance of this interaction is uncertain, but it would clearly be prudent to be on the alert for signs of ergotism in any patient given ergot derivatives and a tetracycline. However, note that one of the manufacturers of ergotamine actually recommends that the concurrent use of tetracycline should be avoided. Impairment of liver function may possibly be a contributory factor in this interaction. 

Vasoconstriction is a well known adverse effect of ergot derivatives, and coronary vasoconstriction may also occur rarely with the triptans. (Note that in 1992, soon after the marketing of sumatriptan, the CSM in the UK had received 34 reports of pain or tightness in the chest caused by sumatriptan, possibly due to coronary vasoconstriction. ) It is therefore theoretically possible that the drugs may have additive vasoconstrictive effects, although there is little evidence of this in practice. 

Nauta, W. j. H., and Domesick, V., 1979, The anatomy of the extrapyramidal system, in Dopaminergic Ergot Derivatives and Motor Function (K. Fuxe and D. Caine, eds.), pp. 3-22, Pergamon Press, New York. 

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