Drug interactions
Amitriptyline + Mifepristone
Severity: Major
Amitriptyline and Mifepristone: 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 can prolong the QT interval, and combined use may increase the risk of torsades de pointes. Mifepristone at the higher doses used for Cushing syndrome carries particular QT concern, and amitriptyline exposure may also rise through CYP2D6 inhibition.
What this interaction means in plain words
Amitriptyline and Mifepristone 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; Mifepristone belongs to Endocrine.
Why it happens
Additive QT prolongation, with possible CYP2D6 inhibition by mifepristone raising amitriptyline levels.
What to do
Use an alternative to amitriptyline if available. If combined, check ECG and electrolytes at baseline and during treatment and consider lowering the amitriptyline dose.
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
Other interactions of Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Amitriptyline with Mifepristone?
MediHelp rates the interaction as major. Amitriptyline and Mifepristone 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 can prolong the QT interval, and combined use may increase the risk of torsades de pointes. Mifepristone at the higher doses used for Cushing syndrome carries particular QT concern, and amitriptyline exposure may also rise through CYP2D6 inhibition.
How serious is the interaction between Amitriptyline and Mifepristone?
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 an alternative to amitriptyline if available. If combined, check ECG and electrolytes at baseline and during treatment and consider lowering the amitriptyline dose.
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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