Ergotamine and nelfinavir
Desk tier: Avoid together
Mechanism: strong CYP3A4 inhibition of clearance (↑ exposure)
“Coadministration of ergotamine with potent CYP 3A4 inhibitors (ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin, and troleandomycin) … ergotamine use is contraindicated with these drugs”
Why this grade
Cafergot (ergotamine/caffeine) label, Contraindications
The Cafergot (ergotamine/caffeine) label lists this combination under Contraindications. CONTRAINDICATIONS: "Coadministration of ergotamine with potent CYP 3A4 inhibitors (ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin, and troleandomycin) … ergotamine use is contraindicated with these drugs" Named in the label: "nelfinavir" Retrieved from DailyMed 2026-10-12.
Cafergot (ergotamine/caffeine) label on DailyMedFDA interaction table
FDA's example-interaction table lists nelfinavir as a strong CYP3A inhibitor. FDA grades the roles; the severity tier on this row is the desk's rule. Table content current as of 2026-05-29.
FDA interaction tableAll pairs for Ergotamine · nelfinavir
Enzyme behind this pair: CYP3A4
Educational reference only. Not FDA-cleared. The Prescribing Information governs.
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