Methergine (Methylergonovine Injection) and Nicotine

Nicotine may increase the effects of methylergonovine in narrowing the blood vessels and decreasing blood flow. A severe decrease in blood flow to the brain and other parts of the body can lead to dangerous side effects. Contact your doctor immediately if you experience coldness, paleness, discoloration, numbness, tingling, or pain in your hands or feet; muscle pain or weakness; severe or worsening headache; blurred vision; severe abdominal pain; chest pain; or shortness of breath while using these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Nicotine may cause vasoconstriction in some patients and potentiate the ischemic response to ergot alkaloids.

MANAGEMENT: Caution may be advisable when ergot alkaloids are used in combination with nicotine products. Patients should be advised to seek immediate medical attention if they experience potential symptoms of ischemia such as coldness, pallor, cyanosis, numbness, tingling, or pain in the extremities; muscle weakness; severe or worsening headache; visual disturbances; severe abdominal pain; chest pain; and shortness of breath.