European Journal of Clinical Pharmacology

, Volume 16, Issue 6, pp 425–426 | Cite as

Ergotism in a patient with a portosystemic shunt

  • V. Hansteen
  • C. Eika
  • S. Birkeland
Short Communications


A case of ergotism is described in a patient with Banti's syndrome in whom a porto-systemic shunt had been made three times. She was admitted to hospital with severe ischaemia of the extremities after having taken a single oral dose of 1 mg ergotamine tartrate. Her condition improved rapidly after 2 to 3 days and the circulation was normal after one week. The possible mechanism of ergotism in this patient is discussed. Although the plasma concentration of ergotamine was not measured, the likeliest explanation was that the serious side effects were related to the altered pharmacokinetics and loss of first-pass metabolism of the drug due to the venous bypass of the liver.

Key words

ergotamine tartrate ergotism Banti's syndrome portosystemic shunt first pass metabolism 


  1. 1.
    Ala-Hurula, V., Myllylä, V.V., Arvela, P., Kärki, N. & Hokkanen, E.: Systemic availability of ergotamine tartrate after oral, rectal and intramuscular administration. Eur. J. Clin. Pharmacol.15, 51–55 (1979)Google Scholar
  2. 2.
    Young, J.R., Humphries, A.W.: Severe arteriospasm after use of ergotamine tartrate suppositories. J. Am. Med. Assoc.175, 1141–1145 (1961)Google Scholar
  3. 3.
    Whelton, M.J., Allaway, A., Stewart, A., Kreel, L.: Ergot poisoning in acute hepatic necrosis. Gut9, 287–289 (1968)Google Scholar
  4. 4.
    Enge, I., Sivertssen, E.: Ergotism due to therapeutic doses of ergotamine tartrate. Am. Heart J.70, 665–670 (1965)Google Scholar
  5. 5.
    Cameron, E.A., French, E.B.: St. Anthony's fire rekindled due to therapeutic doses of ergot. Br. Med. J.1960/II, 28–30Google Scholar

Copyright information

© Springer-Verlag 1979

Authors and Affiliations

  • V. Hansteen
    • 1
  • C. Eika
    • 2
  • S. Birkeland
    • 3
  1. 1.Medical Department VIIIUllevål HospitalOsloNorway
  2. 2.Medical Department IXUllevål HospitalOsloNorway
  3. 3.Surgical Department IIIUllevål HospitalOsloNorway

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