Drug interactions
Amitriptyline + Dextromoramide
Severity: Major
Amitriptyline and Dextromoramide: 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
Dextromoramide is a potent opioid, and combining it with amitriptyline increases sedation and the risk of respiratory depression. The effect is most pronounced in older or frail patients.
What this interaction means in plain words
Amitriptyline and Dextromoramide 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.
Why it happens
Additive CNS and respiratory depression.
What to do
Use the lowest effective opioid dose and titrate slowly, monitoring sedation and respiratory rate. Counsel patients to avoid alcohol and other sedatives.
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
Frequently asked questions
Can I take Amitriptyline with Dextromoramide?
MediHelp rates the interaction as major. Amitriptyline and Dextromoramide 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. Dextromoramide is a potent opioid, and combining it with amitriptyline increases sedation and the risk of respiratory depression. The effect is most pronounced in older or frail patients.
How serious is the interaction between Amitriptyline and Dextromoramide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective opioid dose and titrate slowly, monitoring sedation and respiratory rate. Counsel patients to avoid alcohol and other sedatives.
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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