Drug interactions
Amitriptyline + Buprenorphine
Severity: Moderate
Amitriptyline and Buprenorphine: 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
Both agents can prolong the QT interval, and amitriptyline also has proarrhythmic effects in overdose or in those with cardiac disease. Additive sedation and, rarely, serotonergic effects may also occur.
What this interaction means in plain words
Amitriptyline and Buprenorphine 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; Buprenorphine belongs to Musculoskeletal.
Why it happens
Additive QT prolongation and additive CNS depression.
What to do
Use the lowest effective doses and obtain an ECG in patients with cardiac risk factors or on higher doses. Monitor for sedation and correct electrolyte abnormalities.
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 Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Olanzapine / samidorphan Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + Thioridazine Contraindicated
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 Buprenorphine?
MediHelp rates the interaction as moderate. Amitriptyline and Buprenorphine 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. Both agents can prolong the QT interval, and amitriptyline also has proarrhythmic effects in overdose or in those with cardiac disease. Additive sedation and, rarely, serotonergic effects may also occur.
How serious is the interaction between Amitriptyline and Buprenorphine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and obtain an ECG in patients with cardiac risk factors or on higher doses. Monitor for sedation and correct electrolyte abnormalities.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.
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