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This medication may infrequently lead to severe reduction in blood flow to the extremities (hands and feet) or the brain, potentially resulting in a stroke. The likelihood of this serious condition is heightened when the drug is used alongside other medications that can interfere with the elimination of ergotamine from the body. These include:

• Azole antifungals: ketoconazole, itraconazole
• Drugs such as cobicistat and mifepristone
• Certain antidepressants: nefazodone
• Macrolide antibiotics: clarithromycin, erythromycin, troleandomycin
• HIV protease inhibitors: ritonavir, nelfinavir, indinavir
• SSRIs: fluoxetine, paroxetine, fluvoxamine

It is vital to consult with a healthcare professional regarding any current medications to prevent potential interactions.

When taking this medication, you might experience some common side effects such as nausea, vomiting, restlessness, dizziness, and trouble sleeping. These are generally mild, but if they persist or worsen, it's advisable to consult your healthcare provider for guidance.

In some cases, more serious side effects can occur, and it's important to be vigilant. These include rectal pain or bleeding, irregular heartbeat, tingling or numbness in the fingers or toes, coldness or bluish discoloration in the hands or feet, and muscle pain or weakness. Additionally, if you experience severe stomach or lower back pain, or notice changes in urination patterns, reach out to a healthcare professional promptly.

There are rare but severe side effects that necessitate immediate medical attention. These include chest pain, vision changes, confusion, trouble speaking, and symptoms of a stroke, such as weakness on one side of the body or slurred speech. Poor blood flow to the extremities, characterized by pain, numbness, coldness, or a pale color in the hands or feet, also requires urgent care.

Although a serious allergic reaction to this drug is rare, it is critical to seek emergency medical help if you experience symptoms such as rash, itching or swelling, severe dizziness, or difficulty breathing. Always stay informed about how your body responds to new medications, and consult healthcare professionals with any concerns.