Interaction between Methylergometrine and Methoxamine
Major Synergy

ID DDInter1187 and DDInter1176
Interaction Additive or synergistic increases in blood pressure and/or ischemic response may occur when ergot alkaloids are combined with peripheral or central vasoconstrictors. Ergot alkaloids produce arterial vasoconstriction by stimulating alpha-adrenergic and serotonin receptors and inhibiting endothelial-derived relaxation factor release.
Management Ergot alkaloids should generally not be administered in combination with other vasoconstrictive agents. If concomitant use is required, patients should be monitored for excessive vasoconstriction and have vital signs measured regularly. Patients should also 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.
References
Alternative for Methylergometrine G02A
Alternative for Methoxamine C01C

Potential Metabolism Interactions

Substrate-Substrate Interaction:If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction:Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction:Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.