Drug interactions
Amitriptyline + Desvenlafaxine
Severity: Moderate
Amitriptyline and Desvenlafaxine: 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
Both drugs enhance serotonergic transmission, so together they can cause serotonin syndrome, and desvenlafaxine may add to blood pressure and heart rate effects. Desvenlafaxine has only weak CYP2D6 inhibition, so pharmacokinetic effects are limited.
What this interaction means in plain words
Amitriptyline and Desvenlafaxine 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; Desvenlafaxine belongs to Central Nervous System.
Why it happens
Additive serotonin and norepinephrine reuptake inhibition.
What to do
Start low and titrate slowly, and monitor for agitation, tremor, hyperthermia, clonus and blood pressure rise. Stop one agent if serotonin toxicity develops.
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 Desvenlafaxine
- Desvenlafaxine + Isocarboxazid Contraindicated
- Desvenlafaxine + Methylene blue Contraindicated
- Desvenlafaxine + Phenelzine Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
- Desvenlafaxine + Safinamide Contraindicated
- Desvenlafaxine + Selegiline Contraindicated
Frequently asked questions
Can I take Amitriptyline with Desvenlafaxine?
MediHelp rates the interaction as moderate. Amitriptyline and Desvenlafaxine 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. Both drugs enhance serotonergic transmission, so together they can cause serotonin syndrome, and desvenlafaxine may add to blood pressure and heart rate effects. Desvenlafaxine has only weak CYP2D6 inhibition, so pharmacokinetic effects are limited.
How serious is the interaction between Amitriptyline and Desvenlafaxine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start low and titrate slowly, and monitor for agitation, tremor, hyperthermia, clonus and blood pressure rise. Stop one agent if serotonin toxicity develops.
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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