Drug interactions
Amitriptyline + Nalbuphine
Severity: Moderate
Amitriptyline and Nalbuphine: 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
Amitriptyline is strongly sedating and anticholinergic, so combined use with nalbuphine increases drowsiness, dizziness and CNS depression. Falls, confusion and respiratory depression are more likely in older patients.
What this interaction means in plain words
Amitriptyline and Nalbuphine 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; Nalbuphine belongs to Musculoskeletal.
Why it happens
Additive CNS depressant effects.
What to do
Start with low doses and monitor for oversedation, confusion and respiratory depression, particularly in older adults. Counsel patients to avoid driving and alcohol.
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 Nalbuphine
- Alvimopan + Nalbuphine Contraindicated
- Nalbuphine + Olanzapine / samidorphan Contraindicated
- Alprazolam + Nalbuphine Major
- Amobarbital + Nalbuphine Major
- Benzhydrocodone / acetaminophen + Nalbuphine Major
- Brexanolone + Nalbuphine Major
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 Nalbuphine?
MediHelp rates the interaction as moderate. Amitriptyline and Nalbuphine 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 is strongly sedating and anticholinergic, so combined use with nalbuphine increases drowsiness, dizziness and CNS depression. Falls, confusion and respiratory depression are more likely in older patients.
How serious is the interaction between Amitriptyline and Nalbuphine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and monitor for oversedation, confusion and respiratory depression, particularly in older adults. Counsel patients to avoid driving and alcohol.
What other medicines interact with Nalbuphine?
MediHelp also lists interactions of Nalbuphine with, for example, Alvimopan, Olanzapine / samidorphan, Alprazolam. The full list is on the Nalbuphine page.
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