A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Methergine Side Effects, and Drug Interactions - Methylergonovine Maleate
Methergine Side Effects, and Drug Interactions - Methylergonovine Maleate
SIDE EFFECTS
The most common adverse reaction
is hypertension
associated in several cases with seizure
and or headache. Hypotension
has also been reported. Nausea and vomiting
have occurred occasionally.
Rarely observed reactions have included, in order
of severity: acute myocardial infarction, transient
chest pains, dyspnea,
hematuria, thrombophlebitis,
water intoxication, hallucinations, leg
cramps, dizziness,
tinnitus, nasal congestion,
diarrhea, diaphoresis,
palpitation, and
foul taste.3 There have been rare isolated reports of
anaphylaxis, without
a proven causal relationship to the drug
product.
DRUG ABUSE AND DEPENDENCE
Methergine® (methylergonovine maleate) has not been associated
with drug abuse or dependence
of either a physical
or psychological
nature.
DRUG INTERACTIONS
CYP 3A4 Inhibitors (e.g. Macrolide Antibiotics and Protease Inhibitors)
There have been rare reports of serious adverse events in connection with the coadministration of certain ergot alkaloid drugs (e.g. dihydroergotamine and ergotamine) and potent CYP 3A4 inhibitors, resulting in vasospasm leading to cerebral ischemia and/or ischemia of the extremities. Although there have been no reports of such interactions with methylergonovine alone, potent CYP 3A4 inhibitors should not be coadministered with methylergonovine. Examples of some of the more potent CYP 3A4 inhibitors include macrolide antibiotics (e.g., erythromycin, troleandomycin, clarithromycin), HIV protease or reverse transcriptase inhibitors (e.g., ritonavir, indinavir, nelfinavir, delavirdine) or azole antifungals (e.g., ketoconazole, itraconazole, voriconazole). Less potent CYP 3A4 inhibitors should be administered with caution. Less potent inhibitors include saquinavir, nefazodone, fluconazole, grapefruit juice, fluoxetine, fluvoxamine, zileuton, and clotrimazole. These lists are not exhaustive, and the prescriber should consider the effects on CYP 3A4 of other agents being considered for concomitant use with methylergonovine.
No pharmacokinetic interactions involving other cytochrome P450 isoenzymes are known.
Caution should be exercised when Methergine® (methylergonovine maleate) is used concurrently with other vasoconstrictors or ergot alkaloids.
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