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Drug interactions

Amitriptyline + Ethinyl estradiol-norgestimate

Severity: Minor

Amitriptyline and Ethinyl estradiol-norgestimate: 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.

What this interaction means in plain words

Amitriptyline and Ethinyl estradiol-norgestimate 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-norgestimate belongs to Endocrine.

Evidence level: Low

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.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Amitriptyline with Ethinyl estradiol-norgestimate?

MediHelp rates the interaction as minor. Amitriptyline and Ethinyl estradiol-norgestimate 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.

How serious is the interaction between Amitriptyline and Ethinyl estradiol-norgestimate?

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.

What other medicines interact with Ethinyl estradiol-norgestimate?

MediHelp also lists interactions of Ethinyl estradiol-norgestimate with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Tranexamic acid. The full list is on the Ethinyl estradiol-norgestimate page.

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