Drug interactions
Amitriptyline + Desipramine
Severity: Major
Amitriptyline and Desipramine: 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
Combining two tricyclic antidepressants yields additive QT prolongation, anticholinergic effects and sedation. Amitriptyline is partly metabolised to nortriptyline and both compete for CYP2D6, so levels of either drug can rise unpredictably.
What this interaction means in plain words
Amitriptyline and Desipramine 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; Desipramine belongs to Central Nervous System.
Why it happens
Additive cardiac conduction, anticholinergic and monoamine reuptake effects, with competition for CYP2D6.
What to do
Avoid duplicating tricyclic therapy; choose one agent. If both are unavoidable, monitor ECG and tricyclic plasma levels.
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 Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Other interactions of Desipramine
- Desipramine + Disopyramide Contraindicated
- Desipramine + Dofetilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Desipramine + Isocarboxazid Contraindicated
- Desipramine + Methylene blue Contraindicated
- Desipramine + Pentamidine Contraindicated
Frequently asked questions
Can I take Amitriptyline with Desipramine?
MediHelp rates the interaction as major. Amitriptyline and Desipramine 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. Combining two tricyclic antidepressants yields additive QT prolongation, anticholinergic effects and sedation. Amitriptyline is partly metabolised to nortriptyline and both compete for CYP2D6, so levels of either drug can rise unpredictably.
How serious is the interaction between Amitriptyline and Desipramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid duplicating tricyclic therapy; choose one agent. If both are unavoidable, monitor ECG and tricyclic plasma levels.
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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