Drug interactions
Amitriptyline + Bupropion-naltrexone
Severity: Major
Amitriptyline and Bupropion-naltrexone: 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
Bupropion inhibits CYP2D6 and can markedly raise amitriptyline concentrations, increasing anticholinergic, cardiac and sedative effects. Both drugs also lower the seizure threshold, adding seizure risk.
What this interaction means in plain words
Amitriptyline and Bupropion-naltrexone 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; Bupropion-naltrexone belongs to Miscellaneous.
Why it happens
Bupropion and its metabolites inhibit CYP2D6, reducing tricyclic clearance, with additive lowering of seizure threshold.
What to do
Use a lower starting tricyclic dose and titrate cautiously, monitoring ECG and tricyclic levels if available; avoid in patients with seizure risk.
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 Bupropion-naltrexone
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Bupropion-naltrexone + Isocarboxazid Contraindicated
- Bupropion-naltrexone + Linezolid Contraindicated
- Bupropion-naltrexone + Phenelzine Contraindicated
- Bupropion-naltrexone + Rasagiline 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 Bupropion-naltrexone?
MediHelp rates the interaction as major. Amitriptyline and Bupropion-naltrexone 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. Bupropion inhibits CYP2D6 and can markedly raise amitriptyline concentrations, increasing anticholinergic, cardiac and sedative effects. Both drugs also lower the seizure threshold, adding seizure risk.
How serious is the interaction between Amitriptyline and Bupropion-naltrexone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a lower starting tricyclic dose and titrate cautiously, monitoring ECG and tricyclic levels if available; avoid in patients with seizure risk.
What other medicines interact with Bupropion-naltrexone?
MediHelp also lists interactions of Bupropion-naltrexone with, for example, Hydrocodone, Hydromorphone, Isocarboxazid. The full list is on the Bupropion-naltrexone page.
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