Ergotism and HIV: the risk of self-medication

Abstract

Ergotism is a well-known but rare complication associated with the intake of ergotamine derivatives at doses usually higher than recommended. However, it may also occur after low doses of ergotamine when it is co- administered with drugs that inhibit its metabolism, such as protease inhibitors (PIs), widely used in the treatment of patients with human immunodeficiency virus. Despite this predictable interaction, cases of ergotism are still being observed in daily clinical practice, probably because it is a frequently used, low cost drug that does not require medical prescription, in addition to the patient's lack of knowledge of the potential interactions. We describe here the characteristics, diagnosis, treatment and evolution of four HIV-infected patients on PI-based antiretroviral treatment who presented a clinical picture of ergotism.