Elevated exposure & ergot toxicity w/ CYP3A4 inhibitors eg, macrolides, HIV protease or reverse transcriptase inhibitors, azole antifungals. Vasospastic reactions w/ propranolol. Enhanced vasoconstriction w/ ergot alkaloids-containing prep, sumatriptan, other 5HT1
-receptor agonists, nicotine. Increased plasma exposure to caffeine w/ fluoroquinolones, mexiletine, fluvoxamine, OCs. Increased exposure to ergotamine w/ moderate to weak CYP3A4 inhibitors. Serotonin syndrome w/ serotonin reuptake inhibitors (eg, amitriptyline), SSRIs (eg, sertraline). Reduced pharmacological activity w/ CYP3A4 inducers. Risk of HTN, coronary artery vasoconstriction w/ triptans, phenylpropanolamine, dopaminergic ergot alkaloids, α- & indirect sympathomimetics. Ergotism w/ macrolides, protease & reverse transcriptase inhibitors, voriconazole, quinupristin-dalfopristin, stiripentol, diltiazem, triclabendazole, β-blockers. Increased plasma caffeine conc w/ enoxacin, ciprofloxacin, norfloxacin, mexiletine.