Amitriptyline interactions

Amitriptyline (Elavil), a tricyclic antidepressant has 388 documented interactions across the FDA labels and fact sheets we index: 149 major, 183 moderate, 53 minor, and 3 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

What Amitriptyline looks like

All 71 versions
Amitriptyline 25 mg tablet: yellow, round, 6 mm, imprinted 2102 on one side and V on the other.
2102 / V
25 mg · yellow · round · 6 mm
Thompson Medical Solutions
Amitriptyline 25 mg tablet: green, round, 6 mm, imprinted GG44.
GG44
25 mg · green · round · 6 mm
Sandoz
Amitriptyline 10 mg tablet: pink, round, 6 mm, imprinted GG40.
GG40
10 mg · pink · round · 6 mm
Sandoz
Amitriptyline 10 mg tablet: blue, round, 6 mm, imprinted 2101 on one side and V on the other.
2101 / V
10 mg · blue · round · 6 mm
RedPharm Drug

Renderings from the FDA labels' product listings: color, shape, size, and imprint. 71 documented versions from 22 labelers.

Interactions from the label

Major interactions (149)

  • Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Acetaminophen and codeine label, Boxed warning)

  • AclidiniumanticholinergicMajor

    Avoid administrations of TUDORZA PRESSAIR with other anticholinergic-containing drugs. (Aclidinium label, Drug interactions)

  • AlcoholAlcoholMajor

    Combining alcohol with sedating medicines (opioids, benzodiazepines, sleep medicines, muscle relaxants) can cause dangerous drowsiness, slowed breathing, and overdose. (NIAAA, Harmful Interactions: Mixing Alcohol with Medicines)

  • AlprazolambenzodiazepineMajor

    • Effects on Driving and Operating Machinery: Patients receiving • alprazolam XR should be cautioned against operating machinery or driving a motor vehicle, as well as avoiding concomitant use of alcohol and other central nervous system (CNS) depressant drugs. (Alprazolam label, Warnings and precautions)

  • AmiodaroneantiarrhythmicMajor

    Reserve the combination of amiodarone with other antiarrhythmic therapies that prolong the QTc to patients with life-threatening ventricular arrhythmias who are incompletely responsive to a single agent. (Amiodarone label, Warnings and precautions)

  • Amoxapinetricyclic antidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • AmphetamineCNS stimulantMajor

    Serotonin Syndrome: Increased risk when co-administered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations. (Amphetamine label, Warnings and precautions)

  • Serotonin Syndrome: Increased risk when coadministered with serotonergic agents (e.g., selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans), but also during overdosage situations. (Amphetamine and dextroamphetamine label, Warnings and precautions)

  • AtazanavirantiretroviralMajor

    Antidepressants: tricyclic antidepressants ↑ tricyclic antidepressants Coadministration with REYATAZ has the potential to produce serious and/or life-threatening adverse events and has not been studied. (Atazanavir label, Drug interactions)

  • Azelastine and fluticasoneantihistamineMajor

    • Avoid concurrent use of alcohol or other central nervous system (CNS) depressants with azelastine hydrochloride and fluticasone propionate nasal spray because further decreased alertness and impairment of CNS performance may occur. (Azelastine and fluticasone label, Warnings and precautions)

  • Azithromycinmacrolide antibioticMajor

    This risk which can be fatal should be considered in patients with certain cardiovascular disorders including known QT prolongation or history torsades de pointes, those with proarrhythmic conditions, and with other drugs that prolong the QT interval. (Azithromycin label, Warnings and precautions)

  • …AND MISUSE; LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL EXPOSURE; NEONATAL OPIOD WITHDRAWAL SYNDROME; and RISKS FROM CONCOMITANT USE WITH ALCOHOL, BENZODIAZEPINES OR OTHER CNS DEPRESSANTS Addiction, Abuse, and Misuse Belladonna and opium suppositories expose patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to… (Belladonna and opium label, Boxed warning)

  • BuprenorphineopioidMajor

    Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Buprenorphine label, Boxed warning)

  • Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)

  • BupropionantidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • Buspironeserotonergic drugMajor

    Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs SSRIs, and other serotonergic drugs, including buspirone, alone but particularly with concomitant use of other serotonergic drugs (including triptans), with drugs that impair metabolism of serotonin (in particular, MAOIs, including reversible MAOIs… (Buspirone label, Warnings)

  • Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Butalbital, acetaminophen, caffeine, and codeine label, Boxed warning)

  • Concomitant use of opioids or a barbiturate with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Butalbital, aspirin, caffeine, and codeine label, Boxed warning)

  • ButorphanolopioidMajor

    Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Butorphanol label, Boxed warning)

  • CarbamazepineanticonvulsantMajor

    Known hypersensitivity to any of the tricyclic compounds (e.g., amitriptyline, desipramine, imipramine, protriptyline, and nortriptyline.) Hypersensitivity reactions include anaphylaxis and serious rash. (Carbamazepine label, Contraindications)

  • CarbinoxamineantihistamineMajor

    Avoid concurrent use of Carbinoxamine Maleate Extended-Release Oral Suspension with alcohol or other central nervous system depressants because additional impairment of central nervous system performance may occur. (Carbinoxamine label, Warnings and precautions)

  • CetirizineantihistamineMajor

    Avoid concurrent use of QUZYTTIR with alcohol or other CNS depressants because additional reduction in alertness and additional impairment of CNS performance may occur. (Cetirizine label, Warnings and precautions)

  • CiprofloxacinfluoroquinoloneMajor

    Avoid use in patients with known prolongation, those with hypokalemia, and with other drugs that prolong the QT interval. (Ciprofloxacin label, Warnings and precautions)

  • CitalopramSSRIMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • Clomipraminetricyclic antidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • Clonidinealpha-adrenergic agonistMajor

    Avoid use with other central nervous system (CNS) depressants ( 5.3 ) (Clonidine label, Warnings and precautions)

  • ClozapineantipsychoticMajor

    When possible, avoid concomitant use, with other anticholinergic medications because the risk for anticholinergic toxicity or severe gastrointestinal adverse reactions is increased [see Warnings and Precautions ( 5.7 ), Drug Interactions ( 7.1 )]. (Clozapine label, Warnings and precautions)

  • CodeineopioidMajor

    Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Codeine label, Boxed warning)

  • Cyclobenzaprinemuscle relaxantMajor

    Hyperpyretic crisis seizures and deaths have occurred in patients who received cyclobenzaprine (or structurally similar tricyclic antidepressants) concomitantly with MAO inhibitors drugs. (Cyclobenzaprine label, Contraindications)

  • DarunavirantiretroviralMajor

    …elbasvir/grazoprevir Lipid modifying agents: lomitapide, lovastatin, simvastatin Opioid Antagonist: naloxegol PDE-5 inhibitor: sildenafil when used for treatment of pulmonary arterial hypertension Sedatives/hypnotics: orally administered midazolam, triazolam Co-administration of PREZISTA/ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance… (Darunavir label, Contraindications)

  • Darunavir and cobicistatantiretroviralMajor

    …elbasvir/grazoprevir Lipid modifying agents: lomitapide, lovastatin, simvastatin Opioid Antagonist: naloxegol PDE-5 inhibitor: sildenafil when used for treatment of pulmonary arterial hypertension Sedatives/hypnotics: orally administered midazolam, triazolam PREZCOBIX or PREZCOBIX PED is contraindicated in patients receiving certain co-administered drugs for which altered plasma… (Darunavir and cobicistat label, Contraindications)

  • Desipraminetricyclic antidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • DextroamphetamineCNS stimulantMajor

    Serotonergic Drugs The concomitant use of dextroamphetamine sulfate and serotonergic drugs increases the risk of serotonin syndrome. (Dextroamphetamine label, Drug interactions)

  • Dextromethorphan and quinidineserotonergic drugMajor

    Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (Dextromethorphan and quinidine label, Warnings and precautions)

  • Usage of MOTOFEN ® in recommended doses is not likely to cause prominent anticholinergic side effects, but MOTOFEN ® should be avoided in patients in whom anticholinergic drugs are contraindicated. (Difenoxin and atropine label, Warnings)

  • CONTRAINDICATIONS Diphenoxylate hydrochloride and atropine sulfate is contraindicated in: • Pediatric patients less than 6 years of age due to the risks of respiratory and central nervous system (CNS) depression (see WARNINGS ). (Diphenoxylate and atropine label, Contraindications)

  • DofetilideantiarrhythmicMajor

    Use with Drugs that Prolong QT Interval and Antiarrhythmic Agents The use of dofetilide in conjunction with other drugs that prolong the QT interval has not been studied and is not recommended. (Dofetilide label, Warnings)

  • Doxepintricyclic antidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • DronedaroneantiarrhythmicMajor

    …Pharmacology (12.3) ] • Concomitant use of drugs or herbal products that prolong the QT interval and might increase the risk of torsade de pointes, such as phenothiazine antipsychotics, tricyclic antidepressants, certain oral macrolide antibiotics, and Class I and III antiarrhythmics • Liver or lung toxicity related to the previous use of amiodarone • QTc interval… (Dronedarone label, Contraindications)

  • DuloxetineSNRIMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • EletriptantriptanMajor

    Selective Serotonin Reuptake Inhibitors/Serotonin and Norepinephrine Reuptake Inhibitors and Serotonin Syndrome Cases of serotonin syndrome have been reported during co-administration of triptans and SSRIs, SNRIs, TCAs and MAO inhibitors [see Warnings and Precautions (5.7) ]. (Eletriptan label, Drug interactions)

  • …Lipid-modifying Agents: lomitapide, lovastatin, simvastatin Phosphodiesterase-5 (PDE-5) Inhibitor: sildenafil when administered as REVATIO ® for the treatment of pulmonary arterial hypertension Sedative/hypnotics: triazolam, orally administered midazolam Coadministration of GENVOYA is contraindicated with drugs that: Are highly dependent on CYP3A for clearance and for which… (Elvitegravir, cobicistat, emtricitabine, and tenofovir label, Contraindications)

  • Concomitant use of COMPLERA with drugs with a known risk to prolong the QTc interval of the electrocardiogram may increase the risk of Torsade de Pointes. (Emtricitabine, rilpivirine, and tenofovir label, Warnings and precautions)

  • EscitalopramSSRIMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • Eszopiclonesedative-hypnoticMajor

    The use of LUNESTA with other sedative-hypnotics at bedtime or the middle of the night is not recommended. (Eszopiclone label, Warnings and precautions)

  • FentanylopioidMajor

    • Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Fentanyl label, Boxed warning)

  • Fluconazoleazole antifungalMajor

    Coadministration of other drugs known to prolong the QT interval and which are metabolized via the enzyme CYP3A4 such as erythromycin, pimozide, and quinidine are contraindicated in patients receiving fluconazole. (Fluconazole label, Contraindications)

  • FlumazenilbenzodiazepineMajor

    THESE ARE MOST FREQUENT IN PATIENTS WHO HAVE BEEN ON BENZODIAZEPINES FOR LONG-TERM SEDATION OR IN OVERDOSE CASES WHERE PATIENTS ARE SHOWING SIGNS OF SERIOUS CYCLIC ANTIDEPRESSANT OVERDOSE. (Flumazenil label, Boxed warning)

  • FluoxetineSSRIMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • FluvoxamineSSRIMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • FosamprenavirantiretroviralMajor

    …Hypericum perforatum ) Lipid modifying agents: Lomitapide, lovastatin, simvastatin Non-nucleoside reverse transcriptase inhibitor: Delavirdine PDE5 inhibitor: Sildenafil (Revatio) (for treatment of pulmonary arterial hypertension) Sedative/hypnotics: Midazolam, triazolam Hypersensitivity to fosamprenavir calcium or amprenavir (e.g., Stevens-Johnson syndrome). (Fosamprenavir label, Contraindications)

  • FosfomycinantibioticMajor

    Avoid co-administration of CONTEPO with drugs known to prolong the QT interval. (Fosfomycin label, Drug interactions)

  • FrovatriptantriptanMajor

    Selective Serotonin Reuptake Inhibitors / Serotonin Norepinephrine Reuptake Inhibitors and Serotonin Syndrome Cases of serotonin syndrome have been reported during combined use of triptans and SSRIs, SNRIs, TCAs, and MAO inhibitors [ see Warnings and Precautions (5.7) ]. (Frovatriptan label, Drug interactions)

  • Intervention Concomitant use of anticholinergic drugs with GVOKE VialDx is not recommended. (Glucagon label, Drug interactions)

  • GlycopyrrolateanticholinergicMajor

    • Other Conditions Exacerbated by Anticholinergic Adverse Reactions : Use is not recommended in patients with autonomic neuropathy, hyperthyroidism, cardiac disease, hiatal hernia, etc. (Glycopyrrolate label, Warnings and precautions)

  • GranisetronQT-prolonging drugMajor

    Serotonin syndrome has been reported with granisetron products, alone but particularly with concomitant use of serotonergic drugs. (Granisetron label, Warnings and precautions)

  • HydrocodoneopioidMajor

    Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Hydrocodone label, Boxed warning)

  • Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Hydrocodone and acetaminophen label, Boxed warning)

  • …ABUSE, AND MISUSE; LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; MEDICATION ERRORS; CYTOCHROME P450 3A4 INTERACTION; CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS; INTERACTION WITH ALCOHOL; NEONATAL OPIOID WITHDRAWAL SYNDROME WARNING: ADDICTION, ABUSE, AND MISUSE; LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION;… (Hydrocodone and chlorpheniramine label, Boxed warning)

  • …ABUSE, AND MISUSE; LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; MEDICATION ERRORS; CYTOCHROME P450 3A4 INTERACTION; CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS; INTERACTION WITH ALCOHOL; NEONATAL OPIOID WITHDRAWAL SYNDROME Addiction, Abuse, and Misuse Hydrocodone bitartrate and homatropine methylbromide exposes patients and… (Hydrocodone and homatropine label, Boxed warning)

  • …LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; NEONATAL OPIOID WITHDRAWAL SYNDROME; CYTOCHROME P4503A4 INTERACTION; RISKS FROM CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS; and SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS WARNING: SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYDROCODONE BITARTRATE AND IBUPROFEN TABLETS Addiction,… (Hydrocodone and ibuprofen label, Boxed warning)

  • HydromorphoneopioidMajor

    Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death . (Hydromorphone label, Boxed warning)

  • HydroxychloroquineQT-prolonging drugMajor

    Therefore, PLAQUENIL is not recommended in patients taking other drugs that have the potential to prolong the QT interval. (Hydroxychloroquine label, Warnings and precautions)

  • HydroxyzineantihistamineMajor

    Rarely, cardiac arrests and death have been reported in association with the combined use of hydroxyzine hydrochloride intramuscularly and other CNS depressants. (Hydroxyzine label, Precautions)

  • IloperidoneantipsychoticMajor

    Avoid the use of FANAPT in combination with any other drugs that prolong the QT interval [see Warnings and Precautions (5.3) ] . (Iloperidone label, Drug interactions)

  • Imipraminetricyclic antidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • IpratropiumanticholinergicMajor

    Avoid administration of ATROVENT HFA with other anticholinergic-containing drugs ( 7.1 ) (Ipratropium label, Drug interactions)

  • IsoniazidantibioticMajor

    It should not be given concomitantly with monoamine oxidase inhibitors. (Amitriptyline label, Contraindications)

  • Bradycardia may increase the risk of QT prolongation which may lead to severe ventricular arrhythmias, including torsade de pointes, especially in patients with risk factors such as use of QTc prolonging drugs [see Adverse Reactions ( 6.2 )] . (Ivabradine label, Warnings and precautions)

  • KetamineCNS depressantMajor

    Benzodiazepines, Opioid Analgesics, or other CNS Depressants : Concomitant use may result in profound sedation, respiratory depression, coma, or death. (Ketamine label, Drug interactions)

  • Ketoconazoleazole antifungalMajor

    This may potentiate and prolong hypnotic and sedative effects, especially with repeated dosing or chronic administration of these agents. (Ketoconazole label, Contraindications)

  • LevocetirizineantihistamineMajor

    Avoid concurrent use of alcohol or other central nervous system depressants with XYZAL. (Levocetirizine label, Warnings and precautions)

  • LevofloxacinfluoroquinoloneMajor

    Avoid use in patients with known prolongation, those with hypokalemia, and with other drugs that prolong the QT interval ( 5.11 , 8.5 ) (Levofloxacin label, Warnings and precautions)

  • Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • LevorphanolopioidMajor

    Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Levorphanol label, Boxed warning)

  • LinezolidantibioticMajor

    It should not be given concomitantly with monoamine oxidase inhibitors. (Amitriptyline label, Contraindications)

  • LisdexamfetamineCNS stimulantMajor

    Serotonin Syndrome: Increased risk when co-administered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations. (Lisdexamfetamine label, Warnings and precautions)

  • Lithiumserotonergic drugMajor

    If concomitant use of lithium with other serotonergic drugs is clinically warranted, inform patients of the increased risk for serotonin syndrome and monitor for symptoms. (Lithium label, Warnings and precautions)

  • Lopinavir and ritonavirantiretroviralMajor

    …Non-opioid Analgesic (selective blocker of Nav1.8 sodium channels): suzetrigine PDE5 Inhibitor: sildenafil (Revatio ® ) when used for the treatment of pulmonary arterial hypertension Sedative/Hypnotics: triazolam, orally administered midazolam KALETRA is contraindicated with drugs that are potent CYP3A inducers where significantly reduced lopinavir plasma concentrations… (Lopinavir and ritonavir label, Contraindications)

  • LorazepambenzodiazepineMajor

    Caution patients receiving LOREEV XR against operating machinery or driving a motor vehicle as well to avoid the concomitant use of alcohol and other CNS depressant drugs during treatment ( 5.4 , 7 ) (Lorazepam label, Warnings and precautions)

  • MeperidineopioidMajor

    Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Meperidine label, Boxed warning)

  • Metaxalonemuscle relaxantMajor

    If concomitant use with another CNS depressant is warranted, closely monitor for signs of respiratory depression and sedation, particularly during treatment initiation and dosage increases. (Metaxalone label, Warnings and precautions)

  • MethadoneopioidMajor

    Managing Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, is a risk factor for respiratory depression and death [see Warnings and Precautions ( 5.2 )]. (Methadone label, Boxed warning)

  • MethamphetamineCNS stimulantMajor

    Serotonin Syndrome: Increased risk when coadministered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations. (Methamphetamine label, Warnings and precautions)

  • Methylene blueMAO inhibitorMajor

    It should not be given concomitantly with monoamine oxidase inhibitors. (Amitriptyline label, Contraindications)

  • Metoclopramidedopamine antagonistMajor

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, malignant hyperthermia, drug fever, serotonin syndrome, and primary central nervous system pathology. (Metoclopramide label, Warnings and precautions)

  • MidazolambenzodiazepineMajor

    WARNING: PERSONNEL AND EQUIPMENT FOR MONITORING AND RESUSCITATION AND RISKS FROM CONCOMITANT USE WITH OPIOID ANALGESICS AND OTHER SEDATIVE-HYPNOTICS Personnel and Equipment for Monitoring and Resuscitation Only personnel trained in the administration of procedural sedation, and not involved in the conduct of the diagnostic or therapeutic procedure, should administer… (Midazolam label, Boxed warning)

  • MilnacipranSNRIMajor

    • Serotonin Syndrome : Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Milnacipran label, Warnings and precautions)

  • MirtazapineantidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • MorphineopioidMajor

    Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Morphine label, Boxed warning)

  • NalbuphineopioidMajor

    Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Nalbuphine label, Boxed warning)

  • Nalmefeneopioid antagonistMajor

    Risk of Recurrent Respiratory and CNS Depression : A recurrence of respiratory depression is possible, therefore, keep the patient under continued surveillance and administer repeat doses of ZURNAI using a new auto-injector with each dose while awaiting emergency medical assistance. (Nalmefene label, Warnings and precautions)

  • Naltrexone and bupropionopioid antagonistMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • NaratriptantriptanMajor

    Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors and Serotonin Syndrome Cases of serotonin syndrome have been reported during co-administration of triptans and SSRIs, SNRIs, TCAs, and MAO inhibitors [see Warnings and Precautions (5.7)] . (Naratriptan label, Drug interactions)

  • NefazodoneantidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • …(selective blocker of Na v 1.8 sodium channels): suzetrigine • Opioid antagonists: naloxegol • PDE5 inhibitor: sildenafil (Revatio ® ) when used for pulmonary arterial hypertension (PAH) • Sedative/hypnotics: triazolam, oral midazolam • Serotonin receptor 1A agonist/serotonin receptor 2A antagonist: flibanserin • Vasopressin receptor antagonists: tolvaptan ➢ Drugs that… (Nirmatrelvir and ritonavir label, Contraindications)

  • Nortriptylinetricyclic antidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • Olanzapine and fluoxetineantipsychoticMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • OliceridineopioidMajor

    Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Oliceridine label, Boxed warning)

  • OlopatadineantihistamineMajor

    • Avoid concurrent use of alcohol or other central nervous system depressants with olopatadine hydrochloride nasal solution (nasal spray) ( 5.2 ). (Olopatadine label, Warnings and precautions)

  • Olopatadine and mometasoneantihistamineMajor

    • Avoid concurrent use of alcohol or other central nervous system (CNS) depressants with RYALTRIS because additional reductions in alertness and additional impairment of CNS performance may occur. (Olopatadine and mometasone label, Warnings and precautions)

  • OndansetronQT-prolonging drugMajor

    S e ro t o ni n Syndrome: Serotonin syndrome has been reported with 5-HT 3 receptor antagonists alone but particularly with concomitant use of serotonergic drugs. (Ondansetron label, Warnings and precautions)

  • Avoid coadministration of oxaliplatin injection with medicinal products with a known potential to prolong the QT interval. (Oxaliplatin label, Drug interactions)

  • OxycodoneopioidMajor

    Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Oxycodone label, Boxed warning)

  • …LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; NEONATAL OPIOID WITHDRAWAL SYNDROME; CYTOCHROME P450 3A4 INTERACTION; and RISKS FROM CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS Addiction, Abuse, and Misuse Oxycodone hydrochloride tablets exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to… (Oxycodone and acetaminophen label, Boxed warning)

  • OxymorphoneopioidMajor

    Risks From Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Oxymorphone label, Boxed warning)

  • Palonosetronserotonergic drugMajor

    Serotonin syndrome : reported with 5-HT 3 receptor antagonists alone, but particularly with concomitant use of serotonergic drugs. (Palonosetron label, Warnings and precautions)

  • ParoxetineSSRIMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • Avoid coadministration of VOTRIENT with drugs known to prolong the QT/QTc interval. (Pazopanib label, Drug interactions)

  • …MITIGATION STRATEGY (REMS); LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; NEONATAL OPIOID WITHDRAWAL SYNDROME; and RISKS FROM CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS Addiction, Abuse, and Misuse Pentazocine and Naloxone Tablets exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to… (Pentazocine and naloxone label, Boxed warning)

  • PhenelzineMAO inhibitorMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • PhenobarbitalbarbiturateMajor

    Drugs that Prolong the QT Interval : Avoid concomitant use. (Phenobarbital label, Drug interactions)

  • PimozideantipsychoticMajor

    Because pimozide prolongs the QT interval of the electrocardiogram it is contraindicated in patients with congenital long QT syndrome, patients with a history of cardiac arrhythmias, patients taking other drugs which prolong the QT interval of the electrocardiogram or patients with known hypokalemia or hypomagnesemia (see also PRECAUTIONS - DRUG INTERACTIONS ). (Pimozide label, Contraindications)

  • PitolisantQT-prolonging drugMajor

    The use of WAKIX should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval [see Drug Interactions ( 7.1 )]. (Pitolisant label, Warnings and precautions)

  • Potassium citratepotassium supplementMajor

    In patients in whom there is cause for arrest or delay in tablet passage through the gastrointestinal tract, such as those suffering from delayed gastric emptying, esophageal compression, intestinal obstruction or stricture, or those taking anticholinergic medication. (Potassium citrate label, Contraindications)

  • …PROMETHAZINE AND RESPIRATORY DEPRESSION IN CHILDREN; MEDICATION ERRORS; INTERACTIONS WITH DRUGS AFFECTING CYTOCHROME P450 ISOENZYMES; CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS; NEONATAL OPIOID WITHDRAWAL SYNDROME Addiction, Abuse, and Misuse Promethazine HCl and Codeine Phosphate Oral Solution exposes patients and other users to the risks… (Promethazine and codeine label, Boxed warning)

  • PropafenoneantiarrhythmicMajor

    • Avoid use with other antiarrhythmic agents or drugs that prolong the QT interval. (Propafenone label, Warnings and precautions)

  • Protriptylinetricyclic antidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • QuinidineantiarrhythmicMajor

    Quinidine is also contraindicated in patients who, like those with myasthenia gravis, might be adversely affected by an anticholinergic agent. (Quinidine label, Contraindications)

  • RasagilineMAO inhibitorMajor

    It should not be given concomitantly with monoamine oxidase inhibitors. (Amitriptyline label, Contraindications)

  • RemifentanilopioidMajor

    Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Remifentanil label, Boxed warning)

  • RitonavirantiretroviralMajor

    WARNING: DRUG-DRUG INTERACTIONS LEADING TO POTENTIALLY SERIOUS AND/OR LIFE THREATENING REACTIONS Co-administration of NORVIR with several classes of drugs including sedative hypnotics, antiarrhythmics, or ergot alkaloid preparations may result in potentially serious and/or life-threatening adverse events due to possible effects of NORVIR on the hepatic metabolism… (Ritonavir label, Boxed warning)

  • Rivastigminecholinesterase inhibitorMajor

    Concomitant use with metoclopramide, beta-blockers, or cholinomimetic and anticholinergic drugs is not recommended ( 7.1 , 7.2 , 7.3 ) (Rivastigmine label, Drug interactions)

  • SelegilineMAO inhibitorMajor

    It should not be given concomitantly with monoamine oxidase inhibitors. (Amitriptyline label, Contraindications)

  • SertralineSSRIMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • Sodium oxybateCNS depressantMajor

    Abuse or misuse of illicit GHB, either alone or in combination with other CNS depressants, is associated with CNS adverse reactions, including seizure, respiratory depression, decreases in the level of consciousness, coma, and death [see Warnings and Precautions ( 5.2 )]. (Sodium oxybate label, Boxed warning)

  • St. John's wortHerbal and supplementMajor

    Combining St. John's wort with antidepressants and other serotonergic drugs increases the risk of serotonin syndrome. (NCCIH, St. John's Wort)

  • SumatriptantriptanMajor

    Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors and Serotonin Syndrome Cases of serotonin syndrome have been reported during coadministration of triptans and SSRIs, SNRIs, TCAs, and MAO inhibitors [see Warnings and Precautions (5.7)] . (Sumatriptan label, Drug interactions)

  • Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors and Serotonin Syndrome Clinical Impact: Cases of serotonin syndrome have been reported during coadministration of triptans and SSRIs, SNRIs, TCAs, and MAO inhibitors [see Warnings and Precautions (5.11)] . (Sumatriptan and naproxen label, Drug interactions)

  • TapentadolopioidMajor

    Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Tapentadol label, Boxed warning)

  • TetrabenazineVMAT2 inhibitorMajor

    Certain conditions may increase the risk for torsade de pointes or sudden death such as (1) bradycardia; (2) hypokalemia or hypomagnesemia; (3) concomitant use of other drugs that prolong the QTc interval; and (4) presence of congenital prolongation of the QT interval [see Warnings and Precautions ( 5.8 ), Clinical Pharmacology (12.2) ]. (Tetrabenazine label, Drug interactions)

  • ThioridazineantipsychoticMajor

    CONTRAINDICATIONS Thioridazine hydrochloride tablet use should be avoided in combination with other drugs that are known to prolong the QTc interval and in patients with congenital long QT syndrome or a history of cardiac arrhythmias. (Thioridazine label, Contraindications)

  • TiotropiumanticholinergicMajor

    Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)

  • TramadolopioidMajor

    Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Tramadol label, Boxed warning)

  • Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Tramadol and acetaminophen label, Boxed warning)

  • TranylcypromineMAO inhibitorMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • TrazodoneantidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • TriazolambenzodiazepineMajor

    • Effects on Driving and Operating Heavy Machinery : Patients receiving triazolam should be cautioned against driving or operating heavy machinery, as well as avoiding concomitant use with alcohol and other CNS depressant drugs. (Triazolam label, Warnings and precautions)

  • Trimipraminetricyclic antidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • UmeclidiniumanticholinergicMajor

    Avoid administration of Umeclidinium ELLIPTA with other anticholinergic-containing drugs. (Umeclidinium label, Drug interactions)

  • Umeclidinium and vilanterolanticholinergicMajor

    Avoid administration of Umeclidinium and Vilanterol ELLIPTA with other anticholinergic-containing drugs. (Umeclidinium and vilanterol label, Drug interactions)

  • VenlafaxineSNRIMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • Avoid concomitant use of VEPPANU with strong CYP3A inhibitors or drugs known to prolong the QTc interval. (Vepdegestrant label, Warnings and precautions)

  • VilazodoneSSRIMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • VortioxetineantidepressantMajor

    Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)

  • Zaleplonsedative-hypnoticMajor

    The use of zaleplon with other sedative-hypnotics at bedtime or the middle of the night is not recommended (see ). (Zaleplon label, Warnings)

  • ZiprasidoneantipsychoticMajor

    …drugs, ziprasidone is contraindicated: • in patients with a known history of QT prolongation (including congenital long QT syndrome) • in patients with recent acute myocardial infarction • in patients with uncompensated heart failure Pharmacokinetic/pharmacodynamic studies between ziprasidone and other drugs that prolong the QT interval have not been performed. (Ziprasidone label, Contraindications)

  • Zolpidemsedative-hypnoticMajor

    The use of Zolpidem Tartrate with other sedative-hypnotics (including other zolpidem products) at bedtime or the middle of the night is not recommended. (Zolpidem label, Warnings and precautions)

Moderate interactions (183)

  • Albuterolbeta-adrenergic agonistModerate

    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. (Amitriptyline label, Drug interactions)

  • Allopurinolxanthine oxidase inhibitorModerate

    Inform patients also that the central nervous system depressant effects of allopurinol tablets may be additive to those of alcohol and other CNS depressants. (Allopurinol label, Warnings and precautions)

  • AminophyllinemethylxanthineModerate

    25% increase Diazepam Benzodiazepines increase CNS concentrations of adenosine, a potent CNS depressant, while theophylline blocks adenosine receptors. (Aminophylline label, Drug interactions)

  • Arformoterolbeta-adrenergic agonistModerate

    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. (Amitriptyline label, Drug interactions)

  • AripiprazoleantipsychoticModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology. (Aripiprazole label, Warnings and precautions)

  • ArmodafinilCNS stimulantModerate

    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. (Amitriptyline label, Drug interactions)

  • Articaine and epinephrinelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • AsenapineantipsychoticModerate

    Strenuous exercise, exposure to extreme heat, dehydration, and anticholinergic medications may contribute to an elevation in core body temperature; use SAPHRIS with caution in patient who may experience these conditions. (Asenapine label, Warnings and precautions)

  • Baclofenmuscle relaxantModerate

    Patients should also be cautioned that the central nervous system depressant effects of intrathecal baclofen may be additive to those of alcohol and other CNS depressants. (Baclofen label, Warnings and precautions)

  • Drugs that alter gastrointestinal motility: The bioavailability of thiazide-type diuretics may be increased by anticholinergic agents (e.g., atropine, biperiden), apparently due to a decrease in gastrointestinal motility and the stomach emptying rate. (Benazepril and hydrochlorothiazide label, Drug interactions)

  • BenzphetamineCNS stimulantModerate

    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. (Amitriptyline label, Drug interactions)

  • Sedatives/Hypnotics: midazolam (oral) triazolam ↑ midazolam (oral) ↑ triazolam Use caution when midazolam or triazolam is concomitantly administered with BIXLENVO. (Bictegravir, emtricitabine, and tenofovir alafenamide label, Drug interactions)

  • Drugs that Prolong the QT interval QT prolongation has been reported with metronidazole, a component of bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride, particularly when administered with drugs with the potential for prolonging the QT interval. (Bismuth subcitrate, metronidazole, and tetracycline label, Warnings and precautions)

  • Botulinum toxin type Aneuromuscular blockerModerate

    Aminoglycosides or other agents interfering with neuromuscular transmission Anticholinergic drugs Botulinum neurotoxin products Muscle relaxants Aminoglycoside antibiotics, anticholinergic agents, or any other agents that interfere with neuromuscular transmission may potentiate the effect of DAXXIFY; co-administer only with caution and close observation. (Botulinum toxin type A label, Drug interactions)

  • BrexpiprazoleantipsychoticModerate

    Strenuous exercise, exposure to extreme heat, dehydration, and anticholinergic medications may contribute to an elevation in core body temperature; use REXULTI with caution in patients who may experience these conditions. (Brexpiprazole label, Warnings and precautions)

  • Brimonidinealpha-adrenergic agonistModerate

    Use with CNS depressants may result in an additive or potentiating effect. (Brimonidine label, Drug interactions)

  • Brimonidine and timololalpha-adrenergic agonistModerate

    Use with CNS depressants may result in an additive or potentiating effect. (Brimonidine and timolol label, Drug interactions)

  • 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. (Amitriptyline label, Drug interactions)

  • Budesonide and formoterolcorticosteroidModerate

    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. (Amitriptyline label, Drug interactions)

  • Bupivacainelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • Bupivacaine and epinephrinelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • Butalbital and acetaminophenbarbiturateModerate

    Butalbital and acetaminophen may enhance the effects of:other narcotic analgesics, alcohol, general anesthetics, tranquilizers such as chlordiazepoxide, sedative-hypnotics, or other CNS depressants, causing increased CNS depression. (Butalbital and acetaminophen label, Drug interactions)

  • 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. (Amitriptyline label, Drug interactions)

  • 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. (Amitriptyline label, Drug interactions)

  • Cannabidiol (prescription)anticonvulsantModerate

    Other CNS depressants, including alcohol, could potentiate the somnolence and sedation effect of EPIDIOLEX. (Cannabidiol (prescription) label, Warnings and precautions)

  • CarbidopaModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system (CNS) pathology. (Carbidopa label, Warnings)

  • Carbidopa, levodopa, and entacaponedopaminergic drugModerate

    • Tricyclic antidepressants: risk of hypertension and dyskinesia reported during concomitant use with carbidopa/levodopa ( 7.4 ) (Carbidopa, levodopa, and entacapone label, Drug interactions)

  • CariprazineantipsychoticModerate

    Strenuous exercise, exposure to extreme heat, dehydration, and anticholinergic medications may contribute to an elevation in core body temperature; use VRAYLAR with caution in patient who may experience these conditions. (Cariprazine label, Warnings and precautions)

  • Carisoprodolmuscle relaxantModerate

    • Additive sedative effects when used with other CNS depressants including alcohol (5.1) (Carisoprodol label, Warnings and precautions)

  • CenobamateanticonvulsantModerate

    Concomitant use with other CNS depressants or alcohol may have additive effects. (Cenobamate label, Warnings and precautions)

  • ChlordiazepoxidebenzodiazepineModerate

    The concomitant use of alcohol or other central nervous system depressants may have an additive effect. (Chlordiazepoxide label, Warnings)

  • Chlordiazepoxide and clidiniumbenzodiazepineModerate

    Effects on the Ability to Drive or Operate Machinery As in the case of other preparations containing CNS-acting drugs, patients receiving Librax should be cautioned about possible combined effects with opioids, alcohol and other CNS depressants. (Chlordiazepoxide and clidinium label, Warnings)

  • Chloroprocainelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • Chlorzoxazonemuscle relaxantModerate

    Chlorzoxazone use should also be discontinued if a patient develops abnormal liver enzymes (e.g., AST, ALT, alkaline phosphatase and bilirubin.) The concomitant use of alcohol or other central nervous system depressants may have an additive effect. (Chlorzoxazone label, Warnings and precautions)

  • CimetidineH2 blockerModerate

    Cimetidine is reported to reduce hepatic metabolism of certain tricyclic antidepressants, thereby delaying elimination and increasing steady-state concentrations of these drugs. (Amitriptyline label, Drug interactions)

  • CinacalcetCYP2D6 inhibitorModerate

    QT Interval Prolongation and V entricular A rr h ythmia Decreases in serum calcium can also prolong the QT interval, potentially resulting in ventricular arrhythmia. (Cinacalcet label, Warnings and precautions)

  • ClemastineantihistamineModerate

    Use with CNS Depressants Clemastine has additive effects with alcohol and other CNS depressants (hypnotics, sedatives, tranquilizers, etc.). Use in Activities Requiring Mental Alertness Patients should be warned about engaging in activities requiring mental alertness such as driving a car or operating appliances, machinery, etc. (Clemastine label, Warnings)

  • ClobazambenzodiazepineModerate

    Risk may be increased with concomitant use of other CNS depressants ( 5.4 , 5.5 ) (Clobazam label, Warnings and precautions)

  • ClonazepambenzodiazepineModerate

    They should also be warned about the concomitant use of alcohol or other CNS-depressant drugs during Klonopin therapy (see PRECAUTIONS: Drug Interactions and PRECAUTIONS: Information for Patients ). (Clonazepam label, Warnings)

  • ClorazepatebenzodiazepineModerate

    The actions of the benzodiazepines may be potentiated by barbiturates, narcotics, phenothiazines, monoamine oxidase inhibitors or other antidepressants. (Clorazepate label, Drug interactions)

  • Cocainelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • CyproheptadineantihistamineModerate

    CNS Depressants Antihistamines may have additive effects with alcohol and other CNS depressants, e.g., hypnotics, sedatives, tranquilizers, antianxiety agents. (Cyproheptadine label, Warnings)

  • Daridorexantsedative-hypnoticModerate

    Risk increases when used with other central nervous system (CNS) depressants. (Daridorexant label, Warnings and precautions)

  • DarifenacinanticholinergicModerate

    Darifenacin extended-release tablets, like other anticholinergic drugs, may decrease gastrointestinal motility and should be used with caution in patients with conditions such as severe constipation, ulcerative colitis, and myasthenia gravis. (Darifenacin label, Warnings and precautions)

  • Desfluranegeneral anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • DesmopressinModerate

    Other Drugs that may Increase Risk of Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide,… (Desmopressin label, Drug interactions)

  • DeutetrabenazineVMAT2 inhibitorModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology. (Deutetrabenazine label, Warnings and precautions)

  • DexchlorpheniramineantihistamineModerate

    Use with CNS Depressants CORPHENA Oral Solution has additive effects with alcohol and other CNS depressants (hypnotics, sedatives, tranquilizers, etc.). Use in Activities Requiring Mental Alertness Patients should be warned about engaging in activities requiring mental alertness such as driving a car or operating appliances, machinery, etc. (Dexchlorpheniramine label, Warnings)

  • Dexmedetomidinealpha-adrenergic agonistModerate

    The intravenous administration of anticholinergic agents (e.g., glycopyrrolate, atropine) should be considered to modify vagal tone. (Dexmedetomidine label, Warnings and precautions)

  • DexmethylphenidateCNS stimulantModerate

    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. (Amitriptyline label, Drug interactions)

  • DiazepambenzodiazepineModerate

    …be given to the pharmacology of the agents employed particularly with compounds that may potentiate or be potentiated by the action of Valium, such as phenothiazines, antipsychotics, anxiolytics/sedatives, hypnotics, anticonvulsants, narcotic analgesics, anesthetics, sedative antihistamines, narcotics, barbiturates, MAO inhibitors and other antidepressants. (Diazepam label, Drug interactions)

  • DicyclomineanticholinergicModerate

    Anticholinergic agents: may affect the gastrointestinal absorption of various drugs; may also increase certain actions or side effects of other anticholinergic drugs (7) (Dicyclomine label, Drug interactions)

  • DiethylpropionCNS stimulantModerate

    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. (Amitriptyline label, Drug interactions)

  • DimenhydrinateantihistamineModerate

    The concomitant use of alcohol or other central nervous system depressants may have an additive effect. (Dimenhydrinate label, Warnings)

  • DiphenhydramineantihistamineModerate

    Drug Interactions Diphenhydramine hydrochloride has additive effects with alcohol and other CNS depressants (hypnotics, sedatives, tranquilizers, etc). (Diphenhydramine label, Drug interactions)

  • Divalproex (valproate)anticonvulsantModerate

    Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with Depakote ER ( 7.2 ) (Divalproex (valproate) label, Drug interactions)

  • DobutaminesympathomimeticModerate

    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. (Amitriptyline label, Drug interactions)

  • DronabinolcannabinoidModerate

    Concomitant use of other drugs that cause dizziness, confusion, sedation, or somnolence such as CNS depressants may increase this effect (e.g., barbiturates, benzodiazepines, lithium, opioids, buspirone, scopolamine, antihistamines, tricyclic antidepressants, other anticholinergic agents, and muscle relaxants). (Dronabinol label, Warnings and precautions)

  • Droperidoldopamine antagonistModerate

    …cardiac disease, 3) treatment with Class I and Class III antiarrhythmics, 4) treatment with monoamine oxidase inhibitors (MAOI's), 5) concomitant treatment with other drug products known to prolong the QT interval (see PRECAUTIONS, Drug Interactions ), and 6) electrolyte imbalance, in particular hypokalemia and hypomagnesemia, or concomitant treatment with drugs… (Droperidol label, Warnings)

  • DroxidopasympathomimeticModerate

    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. (Amitriptyline label, Drug interactions)

  • EfavirenzantiretroviralModerate

    QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (Efavirenz label, Drug interactions)

  • QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Efavirenz, lamivudine, and tenofovir label, Drug interactions)

  • EluxadolineopioidModerate

    Examples: alosetron, anticholinergics, opioids Table 3: Established and Other Potentially Clinically Relevant Interactions Affecting Drugs Co-Administered with VIBERZI OATP1B1 and BCRP Substrate Clinical Impact: VIBERZI may increase the exposure of co-administered OATP1B1 and BCRP substrates. (Eluxadoline label, Drug interactions)

  • EphedrinesympathomimeticModerate

    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. (Amitriptyline label, Drug interactions)

  • EpinephrinesympathomimeticModerate

    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. (Amitriptyline label, Drug interactions)

  • Ergotamine and caffeineergot alkaloidModerate

    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. (Amitriptyline label, Drug interactions)

  • EribulinModerate

    QT Prolongation: Monitor for prolonged QT intervals in patients with congestive heart failure, bradyarrhythmias, drugs known to prolong the QT interval, and electrolyte abnormalities. (Eribulin label, Warnings and precautions)

  • EstazolambenzodiazepineModerate

    Although behaviors such as sleep-driving may occur with sedative-hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with sedative-hypnotics appears to increase the risk of such behaviors, as does the use of sedative-hypnotics at doses exceeding the maximum recommended dose. (Estazolam label, Warnings)

  • Etomidategeneral anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • FesoterodineanticholinergicModerate

    Urinary Retention in Adult Patients With Bladder Outlet Obstruction The use of Toviaz, like other antimuscarinic drugs, in patients with clinically significant bladder outlet obstruction, including patients with urinary retention, may result in further urinary retention and kidney injury. (Fesoterodine label, Warnings and precautions)

  • FlibanserinCNS depressantModerate

    Exacerbated by other CNS depressants, and in settings where flibanserin concentrations are increased. (Flibanserin label, Warnings and precautions)

  • FluphenazineantipsychoticModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology. (Fluphenazine label, Warnings)

  • Fluticasone and salmeterolcorticosteroidModerate

    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. (Amitriptyline label, Drug interactions)

  • Formoterolbeta-adrenergic agonistModerate

    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. (Amitriptyline label, Drug interactions)

  • FoscarnetantiviralModerate

    Use with caution in patients who have a history of QT prolongation, in patients who are taking medications known to prolong the QT interval (see PRECAUTIONS section), in patients with electrolyte disturbances, or in patients who have other risk factors for QT prolongation. (Foscarnet label, Warnings)

  • FosphenytoinanticonvulsantModerate

    …Ethosuximide, felbamate, oxcarbazepine, methsuximide, topiramate Azoles Fluconazole, ketoconazole, itraconazole, miconazole, voriconazole Antineoplastic agents Capecitabine, fluorouracil Antidepressants Fluoxetine, fluvoxamine, sertraline Gastric acid reducing agents H 2 antagonists (cimetidine), omeprazole Sulfonamides Sulfamethizole, sulfaphenazole, sulfadiazine,… (Fosphenytoin label, Drug interactions)

  • GabapentinanticonvulsantModerate

    When the decision is made to co-prescribe NEURONTIN with another CNS depressant, particularly an opioid, or to prescribe NEURONTIN to patients with underlying respiratory impairment, monitor patients for symptoms of respiratory depression and sedation, and consider initiating NEURONTIN at a low dose. (Gabapentin label, Warnings and precautions)

  • GefitinibModerate

    Increase IRESSA to 500 mg daily in patients receiving a strong CYP3A4 inducer (e.g., rifampicin, phenytoin, or tricyclic antidepressant) and resume IRESSA at 250 mg 7 days after discontinuation of the strong inducer [see Dosage and Administration (2.4) , Clinical Pharmacology (12.3) ] . (Gefitinib label, Drug interactions)

  • GoserelinModerate

    Effect on QT/QTc Interval: Androgen deprivation therapy may prolong the QT interval. (Goserelin label, Warnings and precautions)

  • HaloperidolantipsychoticModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology. (Haloperidol label, Warnings)

  • IncobotulinumtoxinAneuromuscular blockerModerate

    Because of its anticholinergic effects, XEOMIN should be used with caution in patients at risk of developing narrow angle glaucoma. (IncobotulinumtoxinA label, Warnings and precautions)

  • Ipratropium and albuterolanticholinergicModerate

    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. (Amitriptyline label, Drug interactions)

  • Isofluranegeneral anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • Isoproterenolbeta-adrenergic agonistModerate

    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. (Amitriptyline label, Drug interactions)

  • Itraconazoleazole antifungalModerate

    SSRIs, Tricyclics and Related Antidepressants Venlafaxine Monitor for adverse reactions. (Itraconazole label, Drug interactions)

  • LapatinibP-glycoprotein inhibitorModerate

    TYKERB may prolong the QT interval in some patients. (Lapatinib label, Warnings and precautions)

  • Lemborexantsedative-hypnoticModerate

    Risk increases with dose and use with other central nervous system (CNS) depressants. (Lemborexant label, Warnings and precautions)

  • LeuprolideModerate

    Effect on QT/QTc Interval: Androgen deprivation therapy may prolong the QT interval. (Leuprolide label, Warnings and precautions)

  • Levalbuterolbeta-adrenergic agonistModerate

    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. (Amitriptyline label, Drug interactions)

  • Levothyroxinethyroid hormoneModerate

    Antidepressant Therapy Concurrent use of tricyclic (e.g., amitriptyline) or tetracyclic (e.g., maprotiline) antidepressants and levothyroxine may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. (Levothyroxine label, Drug interactions)

  • Lidocainelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • Lidocaine and epinephrinelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • Lidocaine and prilocainelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • Liothyroninethyroid hormoneModerate

    Antidepressant Therapy Concurrent use of tricyclic (e.g., amitriptyline) or tetracyclic (e.g., maprotiline) antidepressants and liothyronine sodium may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. (Liothyronine label, Drug interactions)

  • Lofexidinealpha-adrenergic agonistModerate

    Risk of QT Prolongation : Lofexidine tablets prolong the QT interval. (Lofexidine label, Warnings and precautions)

  • LoxapineantipsychoticModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system (CNS) pathology. (Loxapine label, Warnings)

  • LumateperoneantipsychoticModerate

    Monitor all antidepressant-treated patients, especially during the initial few months of anti-depressant drug therapy, and at times of dosage changes. (Lumateperone label, Warnings and precautions)

  • LurasidoneantipsychoticModerate

    Activation of Mania/Hypomania Antidepressant treatment can increase the risk of developing a manic or hypomanic episode, particularly in patients with bipolar disorder. (Lurasidone label, Warnings and precautions)

  • MeclizineantihistamineModerate

    • Coadministration of meclizine hydrochloride with other CNS depressants, including alcohol, may result in increased CNS depression ( 7.1 ). (Meclizine label, Drug interactions)

  • MefloquineantimalarialModerate

    Other Drugs that Prolong the QTc Interval Coadministration of other drugs known to alter cardiac conduction (e.g., anti-arrhythmic or beta-adrenergic blocking agents, calcium channel blockers, antihistamines or H 1 -blocking agents, tricyclic antidepressants and phenothiazines) might also contribute to a prolongation of the QTc interval. (Mefloquine label, Drug interactions)

  • Mepivacainelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • MeprobamateCNS depressantModerate

    Additive Effects Since the effects of meprobamate and alcohol or meprobamate and other CNS depressants or psychotropic drugs may be additive,appropriate caution should be exercised with patients who take more than one of these agents simultaneously. (Meprobamate label, Warnings)

  • Methocarbamolmuscle relaxantModerate

    Patients receiving ATMEKSI (methocarbamol) Oral Suspension should be cautioned about combined effects with alcohol and other CNS depressants [ see Drug Interactions (7.1) ]. (Methocarbamol label, Warnings and precautions)

  • MethohexitalbarbiturateModerate

    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. (Amitriptyline label, Drug interactions)

  • MethscopolamineanticholinergicModerate

    Drug interactions Additive anticholinergic effects may result from concomitant use with antipsychotics, tricyclic antidepressants, and other drugs with anticholinergic effects. (Methscopolamine label, Drug interactions)

  • MethylphenidateCNS stimulantModerate

    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. (Amitriptyline label, Drug interactions)

  • MetronidazoleantibioticModerate

    Drugs that Prolong the QT Interval QT prolongation has been reported, particularly when metronidazole was administered with drugs with the potential for prolonging the QT interval. (Metronidazole label, Drug interactions)

  • MetyrosineModerate

    Concurrent use of metyrosine with alcohol or other CNS depressants can increase their sedative effects. (Metyrosine label, Drug interactions)

  • Midodrinealpha-adrenergic agonistModerate

    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. (Amitriptyline label, Drug interactions)

  • MifepristoneCYP3A4 inhibitorModerate

    There is little or no experience with high exposure, concomitant dosing with other QT-prolonging drugs, or potassium channel variants resulting in a long QT interval. [See Warnings & Precautions ( 5.6 )] To minimize risk, the lowest effective dose should always be used. (Mifepristone label, Warnings and precautions)

  • Mirabegronbeta-adrenergic agonistModerate

    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. (Amitriptyline label, Drug interactions)

  • ModafinilCNS stimulantModerate

    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. (Amitriptyline label, Drug interactions)

  • MoxifloxacinfluoroquinoloneModerate

    Pharmacokinetic studies between moxifloxacin and other drugs that prolong the QT interval such as cisapride, erythromycin, antipsychotics, and tricyclic antidepressants have not been performed. (Moxifloxacin label, Warnings and precautions)

  • Naloxoneopioid antagonistModerate

    WARNINGS AND PRECAUTIONS Risk of Recurrent Respiratory and CNS Depression : Due to the duration of action of naloxone relative to the opioid, respiratory and CNS depression may recur after the first dose of naloxone. (Naloxone label, Warnings and precautions)

  • Neostigminecholinesterase inhibitorModerate

    An anticholinergic agent, (e.g., atropine sulfate or glycopyrrolate) should be administered prior to Neostigmine Methylsulfate Injection administration to lessen the risk of bradycardia [ see Dosage and Administration ( 2.4 ) ]. (Neostigmine label, Warnings and precautions)

  • OlanzapineantipsychoticModerate

    Anticholinergic (antimuscarinic) Effects: Use with caution with other anticholinergic drugs and in patients with urinary retention, prostatic hypertrophy, constipation, paralytic ileus or related conditions. (Olanzapine label, Warnings and precautions)

  • OnabotulinumtoxinAneuromuscular blockerModerate

    Anticholinergic Drugs Use of anticholinergic drugs after administration of BOTOX may potentiate systemic anticholinergic effects. (OnabotulinumtoxinA label, Drug interactions)

  • 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. (Amitriptyline label, Drug interactions)

  • OxazepambenzodiazepineModerate

    Patients should be warned that the effects of alcohol or other CNS-depressant drugs may be additive to those of Oxazepam, possibly requiring adjustment of dosage or elimination of such agents. (Oxazepam label, Warnings)

  • OxybutyninanticholinergicModerate

    Oxybutynin chloride extended-release tablets, like other anticholinergic drugs, may decrease gastrointestinal motility and should be used with caution in patients with conditions such as ulcerative colitis and intestinal atony. (Oxybutynin label, Warnings and precautions)

  • OxymetazolinedecongestantModerate

    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. (Amitriptyline label, Drug interactions)

  • PaliperidoneantipsychoticModerate

    …combination with other drugs that are known to prolong QTc including Class 1A (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications, antipsychotic medications (e.g., chlorpromazine, thioridazine), antibiotics (e.g., gatifloxacin, moxifloxacin), or any other class of medications known to prolong the QTc interval. (Paliperidone label, Warnings and precautions)

  • PasireotideModerate

    Drugs that Prolong QT: Use with caution in patients who are at significant risk of developing QTc prolongation. (Pasireotide label, Drug interactions)

  • PerampanelanticonvulsantModerate

    Patients should be carefully observed for signs of central nervous system (CNS) depression, such as somnolence and sedation, when FYCOMPA is used with other drugs with sedative properties because of potential additive effects. (Perampanel label, Warnings and precautions)

  • PerphenazineantipsychoticModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology. (Perphenazine label, Warnings)

  • PhendimetrazineCNS stimulantModerate

    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. (Amitriptyline label, Drug interactions)

  • PhentermineCNS stimulantModerate

    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. (Amitriptyline label, Drug interactions)

  • Phentermine and topiramateCNS stimulantModerate

    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. (Amitriptyline label, Drug interactions)

  • PhenylephrinedecongestantModerate

    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. (Amitriptyline label, Drug interactions)

  • PhenytoinanticonvulsantModerate

    …Ethosuximide, felbamate, oxcarbazepine, methsuximide, topiramate Azoles Fluconazole, ketoconazole, itraconazole, miconazole, voriconazole Antineoplastic agents Capecitabine, fluorouracil Antidepressants Fluoxetine, fluvoxamine, sertraline Gastric acid reducing agents H 2 antagonists (cimetidine), omeprazole Sulfonamides Sulfamethizole, sulfaphenazole, sulfadiazine,… (Phenytoin label, Drug interactions)

  • Physostigminecholinesterase inhibitorModerate

    Acute cardiac arrest may be possible during treatment with tricyclic antidepressants; therefore, Anticholium should only be considered as an antidote for this indication while the patient has continuous ECG monitoring. (Physostigmine label, Warnings and precautions)

  • Pilocarpinecholinergic agonistModerate

    These effects should be considered when anticholinergic properties may be contributing to the therapeutic effect of concomitant medication (e.g., atropine, inhaled ipratropium). (Pilocarpine label, Drug interactions)

  • PonesimodimmunosuppressantModerate

    Anti-Arrhythmic Drugs, QT Prolonging Drugs, Drugs that may Decrease Heart Rate PONVORY has not been studied in patients taking QT prolonging drugs. (Ponesimod label, Drug interactions)

  • Posaconazoleazole antifungalModerate

    Concomitant Use with Midazolam : Noxafil can prolong hypnotic/sedative effects. (Posaconazole label, Warnings and precautions)

  • PregabalinanticonvulsantModerate

    When the decision is made to co-prescribe LYRICA CR with another CNS depressant, particularly an opioid, or to prescribe LYRICA CR to patients with underlying respiratory impairment, monitor patients for symptoms of respiratory depression and sedation, and consider initiating LYRICA CR at a low dose. (Pregabalin label, Warnings and precautions)

  • Prilocaine and epinephrinelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • PrimaquineantimalarialModerate

    QT Interval Prolonging Drugs The pharmacodynamic interaction potential to prolong the QT interval of the electrocardiogram between Primaquine phosphate Tablets and other drugs that effect cardiac conduction is unknown. (Primaquine label, Drug interactions)

  • ProcainamideantiarrhythmicModerate

    Anticholinergic drugs administered concurrently with PA may produce additive antivagal effects on A-V nodal conduction, although this is not as well documented for PA as for quinidine. (Procainamide label, Drug interactions)

  • PromethazineantihistamineModerate

    The impairment may be amplified by concomitant use of other central-nervous-system depressants such as alcohol, sedatives/hypnotics (including barbiturates), narcotics, narcotic analgesics, general anesthetics, tricyclic antidepressants, and tranquilizers; therefore such agents should either be eliminated or given in reduced dosage in the presence of promethazine… (Promethazine label, Warnings)

  • The impairment may be amplified by concomitant use of other central-nervous-system depressants such as alcohol, sedatives/hypnotics (including barbiturates), narcotics, narcotic analgesics, general anesthetics, tricyclic antidepressants, and tranquilizers; therefore such agents should either be eliminated or given in reduced dosage in the presence of promethazine… (Promethazine and dextromethorphan label, Warnings)

  • PropofolCNS depressantModerate

    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. (Amitriptyline label, Drug interactions)

  • PseudoephedrinedecongestantModerate

    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. (Amitriptyline label, Drug interactions)

  • Pyridostigminecholinesterase inhibitorModerate

    Use with caution in persons with increased risk of anticholinergic reactions, such as persons with bronchial asthma, chronic obstructive pulmonary disease, bradycardia, cardiac arrhythmias, beta blocker treatment (increased risk of anticholinergic reactions). (Pyridostigmine label, Warnings and precautions)

  • QuetiapineantipsychoticModerate

    • Anticholinergic (antimuscarinic) Effects: Use with caution with other anticholinergic drugs and in patients with urinary retention, prostatic hypertrophy, or constipation (5.20) (Quetiapine label, Warnings and precautions)

  • Ramelteonsedative-hypnoticModerate

    The use of alcohol and other CNS depressants may increase the risk of such behaviors. (Ramelteon label, Warnings and precautions)

  • RanolazineQT-prolonging drugModerate

    Drugs transported by P-gp (e.g., digoxin), or drugs metabolized by CYP2D6 (e.g., tricyclic antidepressants) may need reduced doses when used with ASPRUZYO Sprinkle. (Ranolazine label, Drug interactions)

  • RifampinantibioticModerate

    …Selective 5-HT 3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline A tuberculosis treatment regimen including rifampin (600 mg/day), isoniazid (300 mg/day), pyrazinamide (500 mg 3× per day), and pyridoxine (25… (Rifampin label, Drug interactions)

  • RifapentineantibioticModerate

    …levonorgestrel Immunosuppressants Cyclosporine, tacrolimus Methylxanthines Theophylline Narcotic analgesics Methadone Phosphodiesterase-5 (PDE-5) Inhibitors Sildenafil Thyroid preparations Levothyroxine Tricyclic antidepressants Amitriptyline, nortriptyline 7.5 Other Interactions The conversion of PRIFTIN to 25-desacetyl rifapentine is mediated by an esterase enzyme. (Rifapentine label, Drug interactions)

  • RilpivirineantiretroviralModerate

    In healthy subjects, 75 mg once daily and 300 mg once daily (3 times and 12 times the dose in EDURANT) have been shown to prolong the QTc interval of the electrocardiogram. (Rilpivirine label, Warnings and precautions)

  • RizatriptantriptanModerate

    The onset of symptoms can occur within minutes to hours of receiving a new or a greater dose of a serotonergic medication. (Rizatriptan label, Warnings and precautions)

  • Rocuroniumneuromuscular blockerModerate

    QT Interval Prolongation The overall analysis of ECG data in pediatric patients indicates that the concomitant use of Rocuronium Bromide Injection with general anesthetic agents can prolong the QTc interval [see Clinical Studies ( 14.3 )]. (Rocuronium label, Warnings and precautions)

  • Ropivacainelocal anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • Salmeterolbeta-adrenergic agonistModerate

    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. (Amitriptyline label, Drug interactions)

  • ScopolamineanticholinergicModerate

    • Gastrointestinal and Urinary Disorders : Consider more frequent monitoring during treatment in patients suspected of having intestinal obstruction; patients with pyloric obstruction, patients with impeded urine flow or receiving other anticholinergic drugs. (Scopolamine label, Warnings and precautions)

  • Sevofluranegeneral anestheticModerate

    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. (Amitriptyline label, Drug interactions)

  • SolifenacinanticholinergicModerate

    Urinary Retention The use of Solifenacin succinate tablets, like other antimuscarinic drugs, in patients with clinically significant bladder outlet obstruction including patients with urinary retention, may result in further urinary retention and kidney injury. (Solifenacin label, Warnings and precautions)

  • SolriamfetolCNS stimulantModerate

    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. (Amitriptyline label, Drug interactions)

  • SorafenibModerate

    Monitor electrolytes and electrocardiograms in patients with congestive heart failure, bradyarrhythmias, drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics. (Sorafenib label, Warnings and precautions)

  • Sotalolbeta blockerModerate

    Additive to other QT-prolonging drugs ( 7.1 , 7.2 ) (Sotalol label, Drug interactions)

  • Succinylcholineneuromuscular blockerModerate

    Pretreatment with anticholinergic agents (e.g., atropine) may reduce the occurrence of bradyarrhythmias. (Succinylcholine label, Warnings and precautions)

  • SugammadexModerate

    Monitor for hemodynamic changes and administer anticholinergic agents such as atropine if clinically significant bradycardia is observed. (Sugammadex label, Warnings and precautions)

  • The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • SunitinibModerate

    Drugs that Prolong QT Interval SUTENT is associated with QTc interval prolongation [see Warnings and Precautions (5.3) , Clinical Pharmacology (12.2) ] . (Sunitinib label, Drug interactions)

  • Suvorexantsedative-hypnoticModerate

    Co-administration with other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol) increases the risk of CNS depression. (Suvorexant label, Warnings and precautions)

  • TemazepambenzodiazepineModerate

    Although behaviors such as “sleep-driving” may occur with temazepam capsules alone at therapeutic doses, the use of alcohol and other CNS depressants with temazepam capsules appear to increase the risk of such behaviors, as does the use of temazepam capsules at doses exceeding the maximum recommended dose. (Temazepam label, Warnings)

  • Terbutalinebeta-adrenergic agonistModerate

    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. (Amitriptyline label, Drug interactions)

  • TheophyllinemethylxanthineModerate

    25% increase Diazepam Benzodiazepines increase CNS concentrations of adenosine, a potent CNS depressant, while theophylline blocks adenosine receptors. (Theophylline label, Drug interactions)

  • ThiothixeneantipsychoticModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology. (Thiothixene label, Warnings)

  • Tizanidinemuscle relaxantModerate

    Sedation: Zanaflex may interfere with everyday activities; sedative effects of Zanaflex, alcohol, and other central nervous system (CNS) depressants are additive ( 5.3 , 7.4 ) (Tizanidine label, Warnings and precautions)

  • TopiramateanticonvulsantModerate

    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. (Amitriptyline label, Drug interactions)

  • Toremifeneselective estrogen receptor modulatorModerate

    …quinidine, procainamide, disopyramide) and Class III (e.g., amiodarone, sotalol, ibutilide, dofetilide) antiarrhythmics; certain antipsychotics (e.g., thioridazine, haloperidol); certain antidepressants (e.g., venlafaxine, amitriptyline); certain antibiotics (e.g., erythromycin, clarithromycin, levofloxacin, ofloxacin); and certain anti-emetics (e.g., ondansetron, granisetron). (Toremifene label, Drug interactions)

  • TrifluoperazineantipsychoticModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology. (Trifluoperazine label, Warnings)

  • TrihexyphenidylanticholinergicModerate

    Concurrent use of alcohol or other CNS depressants with trihexyphenidyl may cause increased sedative effects. (Trihexyphenidyl label, Drug interactions)

  • The recent use of other drugs that cause CNS depression or EPS symptoms may also increase the risk; consider reducing the dosage or discontinuing the drug. (Trimethobenzamide label, Warnings and precautions)

  • TriptorelinModerate

    Effect on QT/QTc Interval: Androgen deprivation therapy may prolong the QT interval. (Triptorelin label, Warnings and precautions)

  • TrospiumanticholinergicModerate

    Trospium chloride extended-release capsules, like other antimuscarinic agents, may decrease gastrointestinal motility and should be used with caution in patients with conditions such as ulcerative colitis, intestinal atony and myasthenia gravis. (Trospium label, Warnings and precautions)

  • ValbenazineVMAT2 inhibitorModerate

    Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology. (Valbenazine label, Warnings and precautions)

  • Valproic acidanticonvulsantModerate

    Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with valproic acid oral solution (7.2) (Valproic acid label, Drug interactions)

  • VasopressinModerate

    Drugs Suspected of Causing SIADH Use with drugs suspected of causing SIADH (e.g., SSRIs, tricyclic antidepressants, haloperidol, chlorpropamide, enalapril, methyldopa, pentamidine, vincristine, cyclophosphamide, ifosfamide, felbamate) may increase the pressor effect in addition to the antidiuretic effect of Vasostrict ® . (Vasopressin label, Drug interactions)

  • Vibegronbeta-adrenergic agonistModerate

    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. (Amitriptyline label, Drug interactions)

  • Voriconazoleazole antifungalModerate

    Eszopiclone (CYP3A4 Inhibition) Not Studied In Vivo or In Vitro , but Drug Plasma Exposure Likely to be Increased which may Increase the Sedative Effect of Eszopiclone Dose reduction of eszopiclone is recommended. (Voriconazole label, Drug interactions)

  • ZolmitriptantriptanModerate

    The onset of symptoms usually rapidly occurs within minutes to hours of receiving a new or a greater dose of a serotonergic medication. (Zolmitriptan label, Warnings and precautions)

  • ZonisamideanticonvulsantModerate

    Caution should be used when ZONISADE is prescribed with other drugs that predispose patients to heat-related disorders; these drugs include, but are not limited to, carbonic anhydrase inhibitors and drugs with anticholinergic activity. (Zonisamide label, Warnings and precautions)

Minor mentions (53)

  • AdenosineantiarrhythmicMinor

    The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). (Amitriptyline label, Drug interactions)

  • AzelastineantihistamineMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • BenztropineanticholinergicMinor

    When benztropine mesylate is given concomitantly with phenothiazines, haloperidol, or other drugs with anticholinergic or antidopaminergic activity, patients should be advised to report gastrointestinal complaints, fever or heat intolerance promptly. (Benztropine label, Warnings)

  • BrivaracetamanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Cevimelinecholinergic agonistMinor

    Cevimeline might interfere with desirable antimuscarinic effects of drugs used concomitantly. (Cevimeline label, Drug interactions)

  • ChlorpheniramineantihistamineMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • ChlorpromazineantipsychoticMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Dantrolenemuscle relaxantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Digoxindigitalis glycosideMinor

    The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). (Amitriptyline label, Drug interactions)

  • Diltiazemcalcium channel blockerMinor

    The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). (Amitriptyline label, Drug interactions)

  • DisopyramideantiarrhythmicMinor

    The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). (Amitriptyline label, Drug interactions)

  • DisulfiramCYP2C9 inhibitorMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Donepezilcholinesterase inhibitorMinor

    Cholinesterase inhibitors have the potential to interfere with the activity of anticholinergic medications ( 7.1 ) (Donepezil label, Drug interactions)

  • In Drug-Induced CNS and Respiratory Depression Doxapram alone may not stimulate adequate spontaneous breathing or provide sufficient arousal in patients who are severely depressed either due to respiratory failure or to CNS depressant drugs, but may be used as an adjunct to established supportive measures and resuscitative techniques. (Doxapram label, Warnings)

  • DoxylamineantihistamineMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Doxylamine and pyridoxineantihistamineMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • The “gasping syndrome” is characterized by central nervous system (CNS) depression, metabolic acidosis, and gasping respirations. (Epoetin alfa label, Warnings and precautions)

  • EslicarbazepineanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Esmololbeta blockerMinor

    The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). (Amitriptyline label, Drug interactions)

  • EthosuximideanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • FelbamateanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • FlecainideantiarrhythmicMinor

    The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). (Amitriptyline label, Drug interactions)

  • Galantaminecholinesterase inhibitorMinor

    Potential to interfere with the activity of anticholinergic medications ( 7.1 ) (Galantamine label, Drug interactions)

  • Guanfacinealpha-adrenergic agonistMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • IbutilideantiarrhythmicMinor

    The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). (Amitriptyline label, Drug interactions)

  • LacosamideanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • LevetiracetamanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Levothyroxine and liothyroninethyroid hormoneMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • LovastatinstatinMinor

    These include itraconazole, ketoconazole, posaconazole, voriconazole, the macrolide antibiotics erythromycin and clarithromycin, the ketolide antibiotic telithromycin, HIV protease inhibitors, boceprevir, telaprevir, the antidepressant nefazodone, or cobicistat-containing products. (Lovastatin label, Warnings)

  • Memantine and donepezilcholinesterase inhibitorMinor

    NAMZARIC may interfere with anticholinergic medications. (Memantine and donepezil label, Drug interactions)

  • Methimazoleantithyroid drugMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • MethsuximideanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • MexiletineantiarrhythmicMinor

    The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). (Amitriptyline label, Drug interactions)

  • Orphenadrinemuscle relaxantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • OxcarbazepineanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • PimavanserinantipsychoticMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Pramipexoledopamine agonistMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Prazosinalpha blockerMinor

    …to date with the following: (1) cardiac glycosides– digitalis and digoxin; (2) hypoglycemics–insulin, chlorpropamide, phenformin, tolazamide, and tolbutamide; (3) tranquilizers and sedatives–chlordiazepoxide, diazepam, and phenobarbital; (4) antigout–allopurinol, colchicine, and probenecid; (5) antiarrhythmics–procainamide, propranolol (see WARNINGS however),… (Prazosin label, Drug interactions)

  • PrimidoneanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • ProchlorperazineantipsychoticMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Propranololbeta blockerMinor

    Antidepressants: The hypotensive effect of MAO inhibitors or tricyclic antidepressants may be exacerbated when administered with beta-blockers. (Propranolol label, Drug interactions)

  • Propylthiouracilantithyroid drugMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • RisperidoneantipsychoticMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Ropiniroledopamine agonistMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • RufinamideanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • Tasimelteonsedative-hypnoticMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • TerbinafineantifungalMinor

    Drugs predominantly metabolized by the CYP450 2D6 isozyme include the following drug classes: tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, antiarrhythmics class 1C (e.g., flecainide and propafenone) and monoamine oxidase inhibitors Type B. (Terbinafine label, Drug interactions)

  • Teriparatidethyroid hormoneMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • TiagabineanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

  • It is difficult to determine if Tolcapone tablets played a role in the pathogenesis of these events because these patients received several concomitant medications affecting the central nervous system such as monoaminergic (i.e., MAO-I, tricyclic and selective serotonin reuptake inhibitors) and anticholinergic agents. (Tolcapone label, Precautions)

  • Verapamilcalcium channel blockerMinor

    The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). (Amitriptyline label, Drug interactions)

  • VigabatrinanticonvulsantMinor

    Guanethidine or similarly acting compounds; thyroid medication; alcohol, barbiturates and other CNS depressants; and disulfiram – see WARNINGS section. (Amitriptyline label, Drug interactions)

No significant interaction reported (3)

  • EntacaponeNo interaction

    No interaction with the tricyclic antidepressant imipramine was shown in a single-dose study with entacapone without coadministered levodopa and dopa-decarboxylase inhibitor. (Entacapone label, Precautions)

  • LenacapavirantiretroviralNo interaction

    Sedatives/Hypnotics: midazolam (oral) triazolam ↑ midazolam (oral) ↑ triazolam Use with caution when midazolam or triazolam is concomitantly administered with SUNLENCA 7.4 Drugs without Clinically Significant Interactions with SUNLENCA Based on drug interaction studies conducted with SUNLENCA, no clinically significant drug interactions have been observed with:… (Lenacapavir label, Drug interactions)

  • Montelukastleukotriene receptor antagonistNo interaction

    …adjustment is needed when SINGULAIR is co-administered with theophylline, prednisone, prednisolone, oral contraceptives, fexofenadine, digoxin, warfarin, gemfibrozil, itraconazole, thyroid hormones, sedative hypnotics, non-steroidal anti-inflammatory agents, benzodiazepines, decongestants, and Cytochrome P450 (CYP) enzyme inducers [see Clinical Pharmacology (12.3) ]. (Montelukast label, Drug interactions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.