Drug interactions
Amitriptyline + Letermovir
Severity: Moderate
Amitriptyline and Letermovir: 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
Letermovir inhibits CYP3A and induces CYP2C9 and CYP2C19, so its net effect on amitriptyline (metabolized by CYP2C19, CYP2D6 and CYP3A4) is unpredictable. Altered tricyclic levels could mean toxicity or reduced effect.
What this interaction means in plain words
Amitriptyline and Letermovir 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; Letermovir belongs to Anti Virals.
Why it happens
Mixed CYP3A inhibition and CYP2C19 induction by letermovir changes amitriptyline metabolism unpredictably.
What to do
Monitor clinical response and tricyclic adverse effects, and consider drug level monitoring or an ECG if symptoms arise. Adjust the dose accordingly.
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 Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Other interactions of Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Amitriptyline with Letermovir?
MediHelp rates the interaction as moderate. Amitriptyline and Letermovir 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. Letermovir inhibits CYP3A and induces CYP2C9 and CYP2C19, so its net effect on amitriptyline (metabolized by CYP2C19, CYP2D6 and CYP3A4) is unpredictable. Altered tricyclic levels could mean toxicity or reduced effect.
How serious is the interaction between Amitriptyline and Letermovir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response and tricyclic adverse effects, and consider drug level monitoring or an ECG if symptoms arise. Adjust the dose accordingly.
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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