Drug interactions
Amitriptyline + Mavacamten
Severity: Moderate
Amitriptyline and Mavacamten: 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
Mavacamten is metabolized mainly by CYP2C19, with a contribution from CYP3A4. Amitriptyline is a substrate of CYP2C19 and may compete with it, which could raise mavacamten exposure and cause excessive reduction in ejection fraction and heart failure. The inhibitory effect of amitriptyline is probably weak.
What this interaction means in plain words
Amitriptyline and Mavacamten 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; Mavacamten belongs to Cardiovascular.
Why it happens
Possible competitive inhibition of CYP2C19-mediated mavacamten metabolism.
What to do
Monitor left ventricular ejection fraction and clinical status per mavacamten labeling when starting or stopping amitriptyline. Adjust the mavacamten dose according to echocardiographic findings.
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 Mavacamten
- Apalutamide + Mavacamten Contraindicated
- Carbamazepine + Mavacamten Contraindicated
- Clarithromycin + Mavacamten Contraindicated
- Dexlansoprazole + Mavacamten Contraindicated
- Efavirenz + Mavacamten Contraindicated
- Enzalutamide + Mavacamten Contraindicated
Frequently asked questions
Can I take Amitriptyline with Mavacamten?
MediHelp rates the interaction as moderate. Amitriptyline and Mavacamten 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. Mavacamten is metabolized mainly by CYP2C19, with a contribution from CYP3A4. Amitriptyline is a substrate of CYP2C19 and may compete with it, which could raise mavacamten exposure and cause excessive reduction in ejection fraction and heart failure. The inhibitory effect of amitriptyline is probably weak.
How serious is the interaction between Amitriptyline and Mavacamten?
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 left ventricular ejection fraction and clinical status per mavacamten labeling when starting or stopping amitriptyline. Adjust the mavacamten dose according to echocardiographic findings.
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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