Drug & supplement interaction

Ephedra + Dihydroergotamine Mesylate

Dihydroergotamine Mesylate brand name: Trudhesa.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Ephedra has a moderate interaction with Dihydroergotamine Mesylate. Theoretically, concomitant use might increase the risk of hypertension.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ephedra and Dihydroergotamine Mesylate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ERGOT DERIVATIVES

Why this applies to Dihydroergotamine Mesylate

Dihydroergotamine Mesylate falls under ERGOT DERIVATIVES — the group Ephedra interacts with.

Theoretically, concomitant use might increase the risk of hypertension.
The ephedrine contained in ephedra might cause excessive vasoconstriction and hypertension when used in combination with ergot derivatives.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with combining ephedra and dihydroergotamine (Trudhesa). Your migraine medicine works partly by tightening blood vessels to stop a headache. Ephedra's main stimulant, ephedrine, also narrows blood vessels and revs up the heart. Put the two together and you can get too much vessel tightening, which may push your blood pressure up and, in rare cases, cause poor circulation to the hands, feet, or other tissues.

This is rated a moderate, likely interaction, though much of it is based on what we know about how each works rather than large studies. On top of that, ephedra itself is banned in U.S. supplements because of serious heart and stroke risks. Please don't use it. Talk with your pharmacist or doctor about safer migraine options.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. White LM, Gardner SF, Gurley BJ, et al. Pharmacokinetics and Cardiovascular Effects of Ma-Huang (Ephedra sinica) in Normotensive Adults. J Clin Pharmacol 1997;37:116-22.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ephedra Also Interacts With Other Medications

Ephedra has 337 major, 495 moderate known drug interactions in our database — the Dihydroergotamine Mesylate one above is one of them. If you take anything else, check it against the full list below.

Major 337 Moderate 495 No known interaction 1,998 (incl. Dihydroergotamine Mesylate)
Taking anything else?

Check Another of Your Medications Against Ephedra

Covers the 2,830 medications we’ve checked against Ephedra. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Dihydroergotamine Mesylate

This page covers Ephedra only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dihydroergotamine Mesylate page lists 139 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Grapefruit (major), Lithium (major), St. John's Wort (major), 5-htp (moderate) and Acacia Rigidula (moderate).

By severity: 3 major · 103 moderate · 33 minor.

From our pharmacist’s overview on the Dihydroergotamine Mesylate page

“Before you pair any supplement with dihydroergotamine mesylate (Trudhesa), a migraine medicine that works partly by tightening blood vessels, understand that this list deserves genuine care. Of the 139 ingredients on file, three rate major: grapefruit, St.”

Reviewed by 2 · Jul 18, 2026

Open the Dihydroergotamine Mesylate interaction page

One more smart check

Taking Ephedra as Part of a Dietary Supplement Product? Check It for Interactions

We hold 37 real supplement products containing Ephedra, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ephedra. Your product may carry other ingredients that interact with Dihydroergotamine Mesylate too, on top of Ephedra — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ephedra and Dihydroergotamine Mesylate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ephedra
Steady interest

#1,049 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Dihydroergotamine Mesylate
Top half

#1,410 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Ephedra

What is Ephedra?

Ephedra
  • Weight loss
  • Nasal and sinus congestion
  • Asthma and breathing problems
  • Boosting energy and athletic performance
  • Allergies

Ephedra (ma huang) contains powerful stimulants like ephedrine that affect the heart and nervous system. Because it has been linked to serious harms including high blood pressure, stroke, and death, it is banned for use in dietary supplements in the U.S. and many other countries. We do not recommend using ephedra-containing supplements; talk to your pharmacist or doctor about safer, approved options.

Read the full Ephedra monograph & all interactions
Keep checking

Other Drugs & Ephedra

Browse every other medication we’ve checked against Ephedra — both the ones with a known interaction and the ones without. Select any drug for the full detail.

337Major
495Moderate
0Minor
1,997No known interaction
337 Major 495 Moderate 1,997 No interaction
Major

337 interactions

Showing 60 of 337 major interactions — see all 337 on the Ephedra page.

Moderate

495 interactions

Showing 60 of 495 moderate interactions — see all 495 on the Ephedra page.

No interaction 1,997 drugs checked — show the list

We also checked Ephedra against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,997 medications checked with no known interaction — see the full Ephedra list.

See the full Ephedra interactions page
See every supplement checked against Dihydroergotamine Mesylate, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Ephedra monograph › Uses, safety, and every drug interaction in one place Dihydroergotamine Mesylate supplement interactions › Every supplement checked against Dihydroergotamine Mesylate, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Ephedra and Dihydroergotamine Mesylate Together: Common Questions

Can you take Ephedra with Dihydroergotamine Mesylate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Ephedra and Dihydroergotamine Mesylate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Dihydroergotamine Mesylate and Ephedra?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.