Protease Inhibitors/Ergot Alkaloids Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Very Serious. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process medicines in the ergot alkaloid family properly.

What might happen:

Your blood levels of the ergot alkaloid may increase and cause chest pain; change in heartbeat; numbness and tingling of your hands, feet, or face; pain in your arms, legs, or lower back; or itching.

What you should do about this interaction:

Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these two medicines together. They may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Agenerase (amprenavir) Oral Solution US prescribing information. GlaxoSmithKline May, 2005.
  • 2.Reyataz (atazanavir sulfate) US prescribing information. Bristol-Myers Squibb Company September, 2020.
  • 3.Reyataz (atazanavir sulfate) Australian product information. Bristol-Myers Squibb Pharmaceuticals January 8, 2004.
  • 4.Prezista (darunavir) US prescribing information. Tibotec Inc. May, 2019.
  • 5.Lexiva (fosamprenavir calcium) US prescribing information. GlaxoSmithKline March, 2019.
  • 6.Crixivan (indinavir sulfate) US prescribing information. Merck & Co., Inc. September, 2016.
  • 7.Kaletra (lopinavir/ritonavir tablets) US prescribing information. Abbott Laboratories December, 2019.
  • 8.Viracept (nelfinavir mesylate) US prescribing information. Agouron Pharmaceuticals, Inc. September, 2016.
  • 9.Fortovase (saquinavir) US prescribing information. Roche Laboratories, Inc. December, 2004.
  • 10.Invirase (saquinavir mesylate) US prescribing information. Roche Laboratories, Inc. March, 2019.
  • 11.Aptivus (tipranavir) US prescribing information. Boehringer Ingelheim Pharmaceuticals, Inc. June, 2020.
  • 12.Norvir (ritonavir) US prescribing information. Abbott Laboratories December, 2019.
  • 13.Methergine (methylergonovine maleate) US prescribing information. Novartis Pharmaceuticals Corporation June, 2012.
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  • 15.Mortier E, Pouchot J, Vinceneux P, Lalande M. Ergotism related to interaction between nelfinavir and ergotamine. Am J Med 2001 May; 110(7):594.
  • 16.Montero A, Giovannoni AG, Tvrde PL. Leg ischemia in a patient receiving ritonavir and ergotamine. Ann Intern Med 1999 Feb 16;130(4 Pt 1):329-30.
  • 17.Caballero-Granado FJ, Viciana P, Cordero E, Gomez-Vera MJ, del Nozal M, Lopez-Cortes LF. Ergotism related to concurrent administration of ergotamine tartrate and ritonavir in an AIDS patient. Antimicrob Agents Chemother 1997 May;41(5):1207.
  • 18.Blanche P, Rigolet A, Gombert B, Ginsburg C, Salmon D, Sicard D. Ergotism related to a single dose of ergotamine tartrate in an AIDS patient treated with ritonavir. Postgrad Med J 1999 Sep;75(887):546-7.
  • 19.Liaudet L, Buclin T, Jaccard C, Eckert P. Drug points: severe ergotism associated with interaction between ritonavir and ergotamine. BMJ 1999 Mar 20;318(7186):771.
  • 20.Pardo Rey C, Yebra M, Borrallo M, Vega A, Ramos A, Montero MC. Irreversible coma, ergotamine, and ritonavir. Clin Infect Dis 2003 Sep 1; 37(5):e72-3.
  • 21.Spiegel M, Schmidauer C, Kampfl A, Sarcletti M, Poewe W. Cerebral ergotism under treatment with ergotamine and ritonavir. Neurology 2001 Aug 28;57(4):743-4.
  • 22.Vila A, Mykietiuk A, Bonvehi P, Temporiti E, Uruena A, Herrera F. Clinical ergotism induced by ritonavir. Scand J Infect Dis 2001; 33(10):788-9.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.