Drug & supplement interaction

Ergot + Palonosetron

Palonosetron brand name: Aloxi.

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

Ergot has a moderate interaction with Palonosetron. Certain ergot alkaloids, such as dihydroergotamine, act as serotonin agonists.

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

Ergot and Palonosetron

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

Moderate

SEROTONERGIC DRUGS

Why this applies to Palonosetron

Palonosetron falls under SEROTONERGIC DRUGS — the group Ergot interacts with.

Certain ergot alkaloids, such as dihydroergotamine, act as serotonin agonists. Theoretically, combining serotonergic drugs with ergot might increase the risk of serotonergic side effects including serotonin syndrome and cerebral vasoconstrictive disorders. Monitor patients for signs of serotonin syndrome and other serotonergic side effects if using ergot with serotonergic drugs.
Serotonergic drugs include the selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft); tricyclic and atypical antidepressants such as amitriptyline (Elavil), clomipramine (Anafranil), and imipramine (Tofranil); triptans such as sumatriptan (Imitrex), zolmitriptan (Zomig), and rizatriptan (Maxalt); opioids such as methadone (Dolophine) and tramadol (Ultram); and many other medications.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Here's the situation with palonosetron (Aloxi) and ergot. Both touch the serotonin system, just in different ways. Palonosetron actually blocks certain serotonin receptors to stop chemo-related nausea, while ergot alkaloids can stimulate serotonin pathways. When two drugs both nudge serotonin signaling, the worry is a rare but serious reaction called serotonin syndrome, with symptoms like agitation, a racing heart, sweating, shivering, muscle twitching, or confusion.

I want to be honest about how strong this concern is: it's mostly theoretical and based on scattered reports, not solid studies. On top of that, raw ergot is genuinely toxic and should never be used as a home remedy. If you're getting palonosetron during chemo, please don't take any ergot product without checking with your oncology team or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3. PubMed
  2. Eadie MJ. Convulsive ergotism: epidemics of the serotonin syndrome? Lancet Neurol 2003;2:429-34. PubMed

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

Ergot Also Interacts With Other Medications

Ergot has 461 moderate known drug interactions in our database — the Palonosetron one above is one of them. If you take anything else, check it against the full list below.

Moderate 461 No known interaction 2,369 (incl. Palonosetron)
Taking anything else?

Check Another of Your Medications Against Ergot

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

Everything else you take

See Every Supplement That Interacts With Palonosetron

This page covers Ergot only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Palonosetron page lists 21 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Lithium (major), 5-htp (moderate), Acetyl-l-carnitine (moderate), Ayahuasca (moderate) and Black Cohosh (moderate).

By severity: 1 major · 18 moderate · 2 minor.

From our pharmacist’s overview on the Palonosetron page

“Palonosetron (Aloxi) prevents nausea and vomiting from chemotherapy, and it works through the serotonin system, which is exactly where every supplement on this list pushes. All 21 entries raise the same concern, adding to serotonin activity and increasing the chance of serotonin syndrome, a reaction that can bring agitation, rapid hear…”

Reviewed by 2 · Jul 18, 2026

Open the Palonosetron interaction page

How much people look this up

Where Ergot and Palonosetron 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 Ergot
Steady interest

#1,002 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Palonosetron
Top half

#1,377 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 Ergot

What is Ergot?

Ergot
  • Heavy menstrual or uterine bleeding
  • Bleeding after childbirth
  • Migraine headaches
  • Stimulating uterine contractions

Ergot is a toxic fungus that grows on rye and contains powerful chemicals (ergot alkaloids) that strongly narrow blood vessels and squeeze the uterus. Because raw ergot is poisonous and the dose is impossible to control safely, it should never be used as a home remedy or supplement. Some purified ergot chemicals are used as prescription drugs under strict medical supervision, but the crude herb is not safe to take.

Read the full Ergot monograph & all interactions
Medication

About Palonosetron Injection

What Is Palonosetron Injection Used For?

Brand name: Aloxi

Palonosetron hydrochloride injection is used in adults to prevent nausea and vomiting caused by moderately or highly emetogenic (nausea-causing) cancer chemotherapy — including both the immediate reaction and the delayed reaction that can happen days later. It is also approved in adults to prevent postoperative nausea and vomiting (PONV) for up to 24 hours after surgery, given right before anesthesia is started.

In children aged 1 month to less than 17 years, it is used to prevent acute (immediate) nausea and vomiting from emetogenic cancer chemotherapy, including highly emetogenic regimens. Posfrea is the brand name under which this intravenous injection is available.

See full Palonosetron Injection drug information
Keep checking

Other Drugs & Ergot

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

0Major
461Moderate
0Minor
2,368No known interaction
461 Moderate 2,368 No interaction
Moderate

461 interactions

Showing 60 of 461 moderate interactions — see all 461 on the Ergot page.

No interaction 2,368 drugs checked — show the list

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

Showing the 60 most looked-up of 2,368 medications checked with no known interaction — see the full Ergot list.

See the full Ergot interactions page
See every supplement checked against Palonosetron, 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
Ergot monograph › Uses, safety, and every drug interaction in one place Palonosetron supplement interactions › Every supplement checked against Palonosetron, ranked by severity Palonosetron Injection drug information › The full plain-English guide to this medication 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 Ergot and Palonosetron Together: Common Questions

Can you take Ergot with Palonosetron?
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 Ergot and Palonosetron 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 Palonosetron and Ergot?

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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.