some macrolide antibiotics (azithromycin / erythromycin etc) are inhibitors of cytochrome p450, particularly cyp3a4. Wikipedia indicates this enzyme group is used in the metabolism of ergotamine (among many many others). Macrolides are contra-indicated to ergot alks because of risk of "ergotism," with no actual studies that I could find. Erythromycin has a half life in the body of 1.5 hours.

soooo... I wonder if medically "ergotism" in this case means gangrene, or intense hallucinations, or both. At the very least I think its important to know that macrolide antibiotics could cause some serious problems with drugs (lsa specifically) and anyone taking them should practice care and safety.

Has anyone accidentally ingested both and experienced any problems/potentiation?

PS gobbling lots of antibiotics without cause is a good way to breed super resistant microbes in the body... be careful with your health.

You are absolutely right in what you say regarding macrolides and certain cytochromic enzymes.I think its reasonable to follow the same advice when using LSA as one would follow using ergotamine or methysergide.Other drugs to be cautious with/avoid if using ergotamine or methysergide include:

1.Tetracyclines

2.The antidepressant reboxetine (MAY cause a marked increase in BP)

3.Variconazole, an anti-fungal drug.

4.Beta blockers (can cause profound vasoconstriction)

5.HIV meds such as amprenavir, indinavir, nelfinovir and ritonavir

6.The anti-migraine 'triptans' used for the acute attack

7.Sympathomimmetics such as pseudoephedrine (increased risk of ergotism).


Have fun people, but play safe

Ergotism is referring to limbs rotting off, not hallucinations. This would be a very bad combo.