Drug interactions
Amitriptyline + Arsenic trioxide
Severity: Major
Amitriptyline and Arsenic trioxide: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Arsenic trioxide causes significant QT prolongation and torsades de pointes, and amitriptyline can add to this effect. The combination raises the risk of life-threatening ventricular arrhythmia.
What this interaction means in plain words
Amitriptyline and Arsenic trioxide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amitriptyline belongs to Central Nervous System; Arsenic trioxide belongs to Oncology.
Why it happens
Additive prolongation of cardiac repolarization.
What to do
Avoid the combination and use a non-QT-prolonging antidepressant. If unavoidable, monitor ECGs closely and keep potassium and magnesium within normal range.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Other interactions of Arsenic trioxide
- Amiodarone + Arsenic trioxide Contraindicated
- Amisulpride + Arsenic trioxide Contraindicated
- Arsenic trioxide + Clomipramine Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Arsenic trioxide + Fluphenazine Contraindicated
- Arsenic trioxide + Gemifloxacin Contraindicated
Frequently asked questions
Can I take Amitriptyline with Arsenic trioxide?
MediHelp rates the interaction as major. Amitriptyline and Arsenic trioxide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Arsenic trioxide causes significant QT prolongation and torsades de pointes, and amitriptyline can add to this effect. The combination raises the risk of life-threatening ventricular arrhythmia.
How serious is the interaction between Amitriptyline and Arsenic trioxide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use a non-QT-prolonging antidepressant. If unavoidable, monitor ECGs closely and keep potassium and magnesium within normal range.
What other medicines interact with Amitriptyline?
MediHelp also lists interactions of Amitriptyline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Amitriptyline page.
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