Drug interactions
Amitriptyline + Carbamazepine
Severity: Moderate
Amitriptyline and Carbamazepine: 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
Carbamazepine induces hepatic enzymes and can lower amitriptyline concentrations, which may reduce antidepressant efficacy. Carbamazepine is structurally similar to tricyclics and can add to anticholinergic and conduction effects.
What this interaction means in plain words
Amitriptyline and Carbamazepine 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; Carbamazepine belongs to Central Nervous System.
Why it happens
Induction of CYP3A4, CYP1A2 and other enzymes by carbamazepine increases amitriptyline clearance.
What to do
Monitor clinical response and consider tricyclic levels, increasing the amitriptyline dose if needed. Reassess the dose if carbamazepine is stopped.
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
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Amitriptyline with Carbamazepine?
MediHelp rates the interaction as moderate. Amitriptyline and Carbamazepine 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. Carbamazepine induces hepatic enzymes and can lower amitriptyline concentrations, which may reduce antidepressant efficacy. Carbamazepine is structurally similar to tricyclics and can add to anticholinergic and conduction effects.
How serious is the interaction between Amitriptyline and Carbamazepine?
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 clinical response and consider tricyclic levels, increasing the amitriptyline dose if needed. Reassess the dose if carbamazepine is stopped.
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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