Drug interactions
Amitriptyline + Atazanavir
Severity: Moderate
Amitriptyline and Atazanavir: moderate 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
Atazanavir, a CYP3A4 inhibitor boosted regimens of which may be used, can raise amitriptyline concentrations. Higher tricyclic levels increase anticholinergic effects, sedation, and cardiac conduction and QT effects.
What this interaction means in plain words
Amitriptyline and Atazanavir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Atazanavir belongs to Anti Virals.
Why it happens
Inhibition of CYP3A4-mediated metabolism of amitriptyline, with possible additional effects from ritonavir or cobicistat boosters.
What to do
Begin with a low amitriptyline dose and titrate to clinical response, monitoring for anticholinergic toxicity and sedation. Consider ECG monitoring or tricyclic serum levels in higher-risk patients.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Amitriptyline with Atazanavir?
MediHelp rates the interaction as moderate. Amitriptyline and Atazanavir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Atazanavir, a CYP3A4 inhibitor boosted regimens of which may be used, can raise amitriptyline concentrations. Higher tricyclic levels increase anticholinergic effects, sedation, and cardiac conduction and QT effects.
How serious is the interaction between Amitriptyline and Atazanavir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Begin with a low amitriptyline dose and titrate to clinical response, monitoring for anticholinergic toxicity and sedation. Consider ECG monitoring or tricyclic serum levels in higher-risk patients.
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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