Drug interactions
Amitriptyline + Artemether / lumefantrine
Severity: Major
Amitriptyline and Artemether / lumefantrine: 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
Artemether/lumefantrine can prolong the QTc interval, and amitriptyline adds to this effect. The combination raises the risk of torsades de pointes and sudden death. Product labeling advises caution with QT-prolonging drugs.
What this interaction means in plain words
Amitriptyline and Artemether / lumefantrine 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.
Why it happens
Additive QT prolongation, and amitriptyline may also compete for CYP2D6 with lumefantrine, which inhibits this enzyme.
What to do
Avoid if possible and use an alternative antimalarial or antidepressant. If unavoidable, obtain an ECG and correct electrolytes.
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
Frequently asked questions
Can I take Amitriptyline with Artemether / lumefantrine?
MediHelp rates the interaction as major. Amitriptyline and Artemether / lumefantrine 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. Artemether/lumefantrine can prolong the QTc interval, and amitriptyline adds to this effect. The combination raises the risk of torsades de pointes and sudden death. Product labeling advises caution with QT-prolonging drugs.
How serious is the interaction between Amitriptyline and Artemether / lumefantrine?
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 if possible and use an alternative antimalarial or antidepressant. If unavoidable, obtain an ECG and correct electrolytes.
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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