Drug interactions
Amitriptyline + Diamorphine
Severity: Major
Amitriptyline and Diamorphine: 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
Diamorphine (heroin) combined with amitriptyline can deepen sedation and add to respiratory depression. Tricyclics may also potentiate opioid effects, so the risk is greater in vulnerable patients.
What this interaction means in plain words
Amitriptyline and Diamorphine 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
Titrate the opioid dose carefully and monitor sedation and respiratory rate. Avoid other CNS depressants and alcohol.
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 Diamorphine?
MediHelp rates the interaction as major. Amitriptyline and Diamorphine 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. Diamorphine (heroin) combined with amitriptyline can deepen sedation and add to respiratory depression. Tricyclics may also potentiate opioid effects, so the risk is greater in vulnerable patients.
How serious is the interaction between Amitriptyline and Diamorphine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate the opioid dose carefully and monitor sedation and respiratory rate. Avoid other CNS depressants and alcohol.
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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