Drug interactions
Amitriptyline + Pitolisant
Severity: Moderate
Amitriptyline and Pitolisant: 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
Pitolisant works by increasing histaminergic transmission in the brain, and centrally acting antihistamines such as amitriptyline can oppose this effect and reduce its efficacy. Amitriptyline also inhibits CYP2D6, and pitolisant is partly metabolised by it. Pitolisant also has a potential for QT prolongation.
What this interaction means in plain words
Amitriptyline and Pitolisant 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; Pitolisant belongs to Central Nervous System.
Why it happens
Central H1 receptor antagonism by amitriptyline counteracts pitolisant's histamine-enhancing effect.
What to do
Avoid this combination where possible, or monitor wakefulness and consider alternative antidepressants. Monitor the ECG in patients at risk of QT prolongation.
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 Pitolisant
- Alfuzosin + Pitolisant Major
- Amiodarone + Pitolisant Major
- Amisulpride + Pitolisant Major
- Anagrelide + Pitolisant Major
- Asenapine + Pitolisant Major
- Bupropion + Pitolisant Major
Frequently asked questions
Can I take Amitriptyline with Pitolisant?
MediHelp rates the interaction as moderate. Amitriptyline and Pitolisant 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. Pitolisant works by increasing histaminergic transmission in the brain, and centrally acting antihistamines such as amitriptyline can oppose this effect and reduce its efficacy. Amitriptyline also inhibits CYP2D6, and pitolisant is partly metabolised by it. Pitolisant also has a potential for QT prolongation.
How serious is the interaction between Amitriptyline and Pitolisant?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid this combination where possible, or monitor wakefulness and consider alternative antidepressants. Monitor the ECG in patients at risk of QT prolongation.
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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