Rilonacept and Dihydroergotamine Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Dihydroergotamine Injection
Rilonacept
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Altered dihydroergotamine plasma concentrations
Interaction Deep Dive
In states of chronic inflammation, the formation of CYP450 enzymes is suppressed by increased levels of cytokines such as interleukin-1 (IL-1). Upon administration of an IL-1 blocker, such as rilonacept, the formation of CYP450 enzymes could be normalized. In patients receiving CYP450 substrates with a narrow therapeutic index concomitantly, such normalization may have a clinically relevant effect on the CYP450 substrate levels. If rilonacept therapy is initiated in a patient being treated with a CYP450 substrate that has a narrow therapeutic index, such as dihydroergotamine, the therapeutic effect of dihydroergotamine should be monitored and dihydroergotamine dose should be adjusted if necessary1.
Why it happens (mechanism)
Interference with CYP450-mediated dihydroergotamine metabolism
Common questions
Can I take Rilonacept and Dihydroergotamine Injection together?
Altered dihydroergotamine plasma concentrations Always confirm with your pharmacist or prescriber before making any change.
How serious is the Rilonacept and Dihydroergotamine Injection interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Rilonacept or Dihydroergotamine Injection need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: ARCALYST(TM) subcutaneous injection, rilonacept subcutaneous injection. Regeneron Pharmaceuticals,Inc, Tarrytown, NY, 2008. DailyMed
Keep reading about Dihydroergotamine Injection
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