Drug interactions
Amitriptyline + Itraconazole
Severity: Moderate
Amitriptyline and Itraconazole: moderate 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
Itraconazole may raise amitriptyline levels and both drugs can prolong the QT interval. The combination raises the risk of anticholinergic effects, sedation and ventricular arrhythmia.
What this interaction means in plain words
Amitriptyline and Itraconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Itraconazole belongs to Anti Fungals.
Why it happens
Itraconazole inhibits CYP3A4 and P-glycoprotein, which may raise amitriptyline exposure, and both agents have additive QT-prolonging effects.
What to do
Obtain a baseline ECG and monitor the QTc and electrolytes. Reduce the amitriptyline dose if toxicity develops, or choose an alternative antifungal.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
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 Itraconazole?
MediHelp rates the interaction as moderate. Amitriptyline and Itraconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Itraconazole may raise amitriptyline levels and both drugs can prolong the QT interval. The combination raises the risk of anticholinergic effects, sedation and ventricular arrhythmia.
How serious is the interaction between Amitriptyline and Itraconazole?
MediHelp rates it moderate, 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 monitor the QTc and electrolytes. Reduce the amitriptyline dose if toxicity develops, or choose an alternative antifungal.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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