ACUTE UPPER EXTREMITY ISCHEMIA DURING CONCOMITANT USE OF ERGOTAMINE TARTRATE AND AMPICILLIN

Individual hypersensitivity to the vasoconstrictor effects of ergotami ne tartrate has been observed even at doses within recommended limits. Hypersensitivity can be induced by concomitant use with other drugs. The best-documented example of drug-induced hypersensitivity to ergota mine tartrate involves antibiotics of the macrolides class. The mechan ism underlying this interaction appears to be interference with metabo lism of ergotamine tartrate by the liver. In the present report we des cribe a case of upper extremity ischemia during concomitant use of erg otamine tartrate and ampicillin. The fact that the effect was not dose -dependent, disappeared when administration of ampicillin was disconti nued, and reappeared when administration of ampicillin was resumed sug gests that the underlying mechanism in our patient was immunologic. Si nce immunologic hypersensitivity to the vasoconstrictor effects of erg otamine tartrate is unpredictable, great caution and close surveillanc e is advisable when ergotamine tartrate is used in association with ot her drugs.