Drug interactions
Amitriptyline + Ethinyl estradiol-levonorgestrel
Severity: Minor
Amitriptyline and Ethinyl estradiol-levonorgestrel: minor 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
Oral contraceptive estrogens may raise amitriptyline plasma concentrations, increasing anticholinergic effects, sedation and orthostatic hypotension. Conversely, high-dose estrogen has been reported to blunt antidepressant response in some patients. The clinical effect varies between individuals.
What this interaction means in plain words
Amitriptyline and Ethinyl estradiol-levonorgestrel have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Amitriptyline belongs to Central Nervous System; Ethinyl estradiol-levonorgestrel belongs to Endocrine.
Why it happens
Estrogens may reduce oxidative hepatic metabolism of tricyclic antidepressants; the exact mechanism is not firmly established.
What to do
Monitor for tricyclic adverse effects and for changes in antidepressant response after starting or stopping the contraceptive. Adjust the amitriptyline dose according to clinical response or serum level if needed.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Ethinyl estradiol-levonorgestrel
- Ethinyl estradiol-levonorgestrel + Fezolinetant Contraindicated
- Ethinyl estradiol-levonorgestrel + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-levonorgestrel + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-levonorgestrel Major
- Amobarbital + Ethinyl estradiol-levonorgestrel Major
- Anastrozole + Ethinyl estradiol-levonorgestrel Major
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 Ethinyl estradiol-levonorgestrel?
MediHelp rates the interaction as minor. Amitriptyline and Ethinyl estradiol-levonorgestrel have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Oral contraceptive estrogens may raise amitriptyline plasma concentrations, increasing anticholinergic effects, sedation and orthostatic hypotension. Conversely, high-dose estrogen has been reported to blunt antidepressant response in some patients. The clinical effect varies between individuals.
How serious is the interaction between Amitriptyline and Ethinyl estradiol-levonorgestrel?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for tricyclic adverse effects and for changes in antidepressant response after starting or stopping the contraceptive. Adjust the amitriptyline dose according to clinical response or serum level if needed.
What other medicines interact with Ethinyl estradiol-levonorgestrel?
MediHelp also lists interactions of Ethinyl estradiol-levonorgestrel with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Tranexamic acid. The full list is on the Ethinyl estradiol-levonorgestrel page.
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