Drug interactions
Amitriptyline + Fluphenazine
Severity: Major
Amitriptyline and Fluphenazine: 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
Both agents can prolong the QT interval, so combining them increases the risk of torsades de pointes. Additive anticholinergic and sedative effects occur, and fluphenazine may raise tricyclic levels via CYP2D6 competition.
What this interaction means in plain words
Amitriptyline and Fluphenazine 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.
Amitriptyline belongs to Central Nervous System; Fluphenazine belongs to Central Nervous System.
Why it happens
Additive QT prolongation and anticholinergic effects, with competition at CYP2D6.
What to do
Obtain a baseline ECG and correct electrolyte disturbances, then monitor the QTc after dose changes. Choose alternatives in patients with other QT risk factors.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Amitriptyline and Fluphenazine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Fluphenazine
- Arsenic trioxide + Fluphenazine Contraindicated
- Dofetilide + Fluphenazine Contraindicated
- Fluphenazine + Ibutilide Contraindicated
- Fluphenazine + Pimozide Contraindicated
- Adagrasib + Fluphenazine Major
- Alfentanil + Fluphenazine Major
Frequently asked questions
Can I take Amitriptyline with Fluphenazine?
MediHelp rates the interaction as major. Amitriptyline and Fluphenazine 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. Both agents can prolong the QT interval, so combining them increases the risk of torsades de pointes. Additive anticholinergic and sedative effects occur, and fluphenazine may raise tricyclic levels via CYP2D6 competition.
How serious is the interaction between Amitriptyline and Fluphenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and correct electrolyte disturbances, then monitor the QTc after dose changes. Choose alternatives in patients with other QT risk factors.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
