Drug interactions
Amitriptyline + Butalbital
Severity: Moderate
Amitriptyline and Butalbital: 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
Butalbital is a barbiturate that can induce enzymes and lower amitriptyline exposure, potentially weakening its therapeutic effect. Both agents are sedating, so drowsiness and impaired psychomotor performance may be additive.
What this interaction means in plain words
Amitriptyline and Butalbital 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.
Why it happens
Induction of CYP2C19 and CYP3A4 metabolism of amitriptyline, plus additive CNS depression.
What to do
Monitor for loss of antidepressant or analgesic benefit and adjust the amitriptyline dose accordingly. Counsel on sedation and avoid alcohol.
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
Frequently asked questions
Can I take Amitriptyline with Butalbital?
MediHelp rates the interaction as moderate. Amitriptyline and Butalbital 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. Butalbital is a barbiturate that can induce enzymes and lower amitriptyline exposure, potentially weakening its therapeutic effect. Both agents are sedating, so drowsiness and impaired psychomotor performance may be additive.
How serious is the interaction between Amitriptyline and Butalbital?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of antidepressant or analgesic benefit and adjust the amitriptyline dose accordingly. Counsel on sedation and avoid alcohol.
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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