The simultaneous use of
ergot derivatives is contraindicated with all
triptans because of the theoretical risk of additive vasoconstriction, although there is some evidence of safe use.
In the UK the manufacturers of
sumatriptan say that ergotamine should not be given less than 6 hours after taking
sumatriptan, and recommend that
sumatriptan should not be taken less than 24 hours after taking ergotamine. Similar recommendations are made by the manufacturers of
almotriptan, rizatriptan, and
zolmitriptan, whereas the manufacturers of eletriptan and
frovatriptan recommend that
ergot derivatives are not given for a minimum of 24 hours (not just 6 hours) after these
triptans. In general, in the US, it is recommended that
triptans and ergotamine or ergot-type medication should not be taken within 24 hours of each other.