Drug interactions
Amitriptyline + Levorphanol
Severity: Major
Amitriptyline and Levorphanol: 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 drugs depress the CNS, and together they can cause additive sedation, psychomotor impairment and respiratory depression. Amitriptyline may also add serotonergic risk with some opioids. Risk is greatest in elderly patients and at higher doses.
What this interaction means in plain words
Amitriptyline and Levorphanol 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.
Why it happens
Additive CNS and respiratory depression, with possible serotonergic contribution.
What to do
Use the lowest effective doses and monitor sedation and respiratory rate, especially at initiation and dose changes. Counsel patients about driving and alcohol.
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?
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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
Frequently asked questions
Can I take Amitriptyline with Levorphanol?
MediHelp rates the interaction as major. Amitriptyline and Levorphanol 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 drugs depress the CNS, and together they can cause additive sedation, psychomotor impairment and respiratory depression. Amitriptyline may also add serotonergic risk with some opioids. Risk is greatest in elderly patients and at higher doses.
How serious is the interaction between Amitriptyline and Levorphanol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor sedation and respiratory rate, especially at initiation and dose changes. Counsel patients about driving and alcohol.
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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