Drug interactions
Amitriptyline + Promazine
Severity: Major
Amitriptyline and Promazine: major interaction.
Last updated Sources: US FDA label
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 both have sedative and anticholinergic effects. The combination raises the risk of torsades de pointes, particularly with electrolyte disturbances or heart disease. Promazine may also raise tricyclic levels through CYP2D6 competition.
What this interaction means in plain words
Amitriptyline and Promazine 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.
Why it happens
Additive QT prolongation and additive anticholinergic and sedative effects, with possible CYP2D6 competition.
What to do
Avoid the combination where possible. If both are needed, monitor the ECG, correct potassium and magnesium, and watch for sedation and anticholinergic toxicity.
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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References
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 Promazine?
MediHelp rates the interaction as major. Amitriptyline and Promazine 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 both have sedative and anticholinergic effects. The combination raises the risk of torsades de pointes, particularly with electrolyte disturbances or heart disease. Promazine may also raise tricyclic levels through CYP2D6 competition.
How serious is the interaction between Amitriptyline and Promazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible. If both are needed, monitor the ECG, correct potassium and magnesium, and watch for sedation and anticholinergic toxicity.
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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