ERGOT DERIVATIVES AND PROTEASE INHIBITORS

A patient taking indinavir rapidly developed ergotism after taking usual doses of
ergotamine. At least 6 other patients taking ritonavir with ergotamine have had the
same reaction. A patient taking nelfinavir developed peripheral arterial vasoconstric-
tion after taking ergotamine. Other ergot derivatives and protease inhibitors are
predicted to interact similarly.
The manufacturers of many ergot derivatives generally contraindicate potent
CYP3A4 inhibitors, which would include the protease inhibitors.
(29)
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