Drug interactions
Amitriptyline + Belladonna and opium
Severity: Major
Amitriptyline and Belladonna and opium: 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
Belladonna alkaloids add antimuscarinic effects to those of amitriptyline, while opium contributes opioid sedation and constipation. Together they can cause marked drowsiness, urinary retention, severe constipation, and confusion, with possible respiratory depression.
What this interaction means in plain words
Amitriptyline and Belladonna and opium 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 antimuscarinic effects plus additive CNS and respiratory depression from the opioid.
What to do
Avoid the combination in older patients and those with urinary retention, glaucoma, or ileus; otherwise use the lowest opioid dose. Monitor sedation, respiratory rate, and bowel and bladder function.
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 Belladonna and opium?
MediHelp rates the interaction as major. Amitriptyline and Belladonna and opium 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. Belladonna alkaloids add antimuscarinic effects to those of amitriptyline, while opium contributes opioid sedation and constipation. Together they can cause marked drowsiness, urinary retention, severe constipation, and confusion, with possible respiratory depression.
How serious is the interaction between Amitriptyline and Belladonna and opium?
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 in older patients and those with urinary retention, glaucoma, or ileus; otherwise use the lowest opioid dose. Monitor sedation, respiratory rate, and bowel and bladder function.
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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