What the FDA labels say about taking them together
Dihydroergotamine and ensitrelvir
Ensitrelvir's FDA label of June 3, 2026 names dihydroergotamine in its drug interactions section; the dihydroergotamine labels PlainMeds reads (4) do not name ensitrelvir. The ensitrelvir label: “Co-administration is contraindicated due to potential for acute ergot toxicity characterized by vasospasm and ischemia of the extremities and other tissues, including the central nervous system.”
Check it at the source: the dihydroergotamine FDA label on DailyMed (effective March 6, 2025, Oceanside Pharmaceuticals); the ensitrelvir FDA label on DailyMed (effective June 3, 2026, Shionogi Inc.).
What does the dihydroergotamine label say about ensitrelvir?
Dihydroergotamine's label (effective March 6, 2025) and its 3 other brand-application labels do not name ensitrelvir in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (Dihydroergotamine Mesylate), NDA020148 (Bausch), as published by Oceanside Pharmaceuticals, effective March 6, 2025 (SPL set 977de209-c53a-4cb4-9f3f-1e850600a9dc), via openFDA; the full label on DailyMed
What does the ensitrelvir label say about dihydroergotamine?
Ensitrelvir label, drug interactionsDrug Class: Ergot derivatives; Drug (s) within Class: dihydroergotamine, ergotamine, methylergonovine; Effect on Drug Concentration: ↑ dihydroergotamine, ergotamine, methylergonovine; Clinical Comment: Co-administration is contraindicated due to potential for acute ergot toxicity characterized by vasospasm and ischemia of the extremities and other tissues, including the central nervous system.
Source: FDA drug label (XOCOVA), Shionogi Inc., effective June 3, 2026 (SPL set 526acf60-abc3-2cc2-e063-6294a90affa6), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Dihydroergotamine | Ensitrelvir | |
|---|---|---|
| Labeled for | Migraine | COVID-19 |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $29.44 per mL 4 mg/mL nasal spray | n/a |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once