Drug interactions
Amitriptyline + Bupropion
Severity: Major
Amitriptyline and Bupropion: 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 raise amitriptyline and nortriptyline concentrations, increasing anticholinergic, sedative and cardiac effects. Both drugs also lower the seizure threshold, so seizure risk is increased.
What this interaction means in plain words
Amitriptyline and Bupropion 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 belongs to Central Nervous System.
Why it happens
Bupropion and hydroxybupropion inhibit CYP2D6, and both drugs have additive seizure-threshold lowering effects.
What to do
Use the lowest effective doses and consider reducing the tricyclic dose. Monitor ECG and tricyclic levels where available, and watch for seizures or toxicity.
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
- Bupropion + Isocarboxazid Contraindicated
- Bupropion + Linezolid Contraindicated
- Bupropion + Phenelzine Contraindicated
- Bupropion + Rasagiline Contraindicated
- Bupropion + Selegiline Contraindicated
- Bupropion + Selegiline transdermal 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?
MediHelp rates the interaction as major. Amitriptyline and Bupropion 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 raise amitriptyline and nortriptyline concentrations, increasing anticholinergic, sedative and cardiac effects. Both drugs also lower the seizure threshold, so seizure risk is increased.
How serious is the interaction between Amitriptyline and Bupropion?
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 the lowest effective doses and consider reducing the tricyclic dose. Monitor ECG and tricyclic levels where available, and watch for seizures or toxicity.
What other medicines interact with Bupropion?
MediHelp also lists interactions of Bupropion with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Bupropion page.
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