Drug interactions
Amitriptyline + Nefopam
Severity: Moderate
Amitriptyline and Nefopam: 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
Nefopam has sympathomimetic and anticholinergic properties, and amitriptyline shares these. Together they may cause tachycardia, dry mouth, urinary retention, and sedation, and nefopam is generally cautioned with tricyclics.
What this interaction means in plain words
Amitriptyline and Nefopam 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; Nefopam belongs to Central Nervous System.
Why it happens
Additive anticholinergic and noradrenergic effects, as nefopam inhibits monoamine reuptake like the tricyclic.
What to do
Monitor heart rate and anticholinergic symptoms such as urinary retention. Use a lower nefopam dose and avoid in patients with arrhythmia, glaucoma, or urinary retention.
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 Nefopam
- Clomipramine + Nefopam Moderate
- Desipramine + Nefopam Moderate
- Imipramine + Nefopam Moderate
- Maprotiline + Nefopam Moderate
- Nefopam + Nortriptyline Moderate
- Nefopam + Trazodone Moderate
Frequently asked questions
Can I take Amitriptyline with Nefopam?
MediHelp rates the interaction as moderate. Amitriptyline and Nefopam 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. Nefopam has sympathomimetic and anticholinergic properties, and amitriptyline shares these. Together they may cause tachycardia, dry mouth, urinary retention, and sedation, and nefopam is generally cautioned with tricyclics.
How serious is the interaction between Amitriptyline and Nefopam?
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 heart rate and anticholinergic symptoms such as urinary retention. Use a lower nefopam dose and avoid in patients with arrhythmia, glaucoma, or urinary retention.
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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