Drug interactions
Amitriptyline + Cyclosporine
Severity: Moderate
Amitriptyline and Cyclosporine: 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
Cyclosporine can inhibit CYP3A4 and P-glycoprotein and may raise amitriptyline concentrations, with case reports of tricyclic toxicity. Elevated levels may bring anticholinergic effects, sedation, and arrhythmia risk.
What this interaction means in plain words
Amitriptyline and Cyclosporine 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
Inhibition of CYP3A4 and P-glycoprotein, reducing amitriptyline clearance.
What to do
Monitor for tricyclic toxicity and consider tricyclic serum levels and an ECG, reducing the dose if needed. Also follow cyclosporine levels when therapy changes.
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 Cyclosporine?
MediHelp rates the interaction as moderate. Amitriptyline and Cyclosporine 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. Cyclosporine can inhibit CYP3A4 and P-glycoprotein and may raise amitriptyline concentrations, with case reports of tricyclic toxicity. Elevated levels may bring anticholinergic effects, sedation, and arrhythmia risk.
How serious is the interaction between Amitriptyline and Cyclosporine?
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 tricyclic toxicity and consider tricyclic serum levels and an ECG, reducing the dose if needed. Also follow cyclosporine levels when therapy changes.
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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