التداخل بين أميتريبتيلين وفينترمين وتوبيرامات

Drug Interactions Topiramate Some patients may experience a large increase in amitriptyline concentration in the presence of topiramate and any adjustments in amitriptyline dose should be made according to the patient's clinical response and not on the basis of plasma levels.

When amitriptyline is given with anticholinergic agents or sympathomimetic drugs, including epinephrine combined with local anesthetics, close supervision and careful adjustment of dosages are required.

Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section.

Amitriptyline Clinical Impact Some patients may experience a large increase in amitriptyline concentration in the presence of topiramate.

Intervention Any adjustments in amitriptyline dose when used with phentermine and topiramate extended-release capsules should be made according to the patient's clinical response and not on the basis of amitriptyline levels [see Clinical Pharmacology (12.3) ] .