Drug interactions
Amitriptyline + Pyridostigmine
Severity: Moderate
Amitriptyline and Pyridostigmine: 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's anticholinergic effects oppose the cholinergic action of pyridostigmine and may weaken its effect in myasthenia gravis. The magnitude varies between patients.
What this interaction means in plain words
Amitriptyline and Pyridostigmine 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; Pyridostigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between muscarinic blockade and cholinesterase inhibition.
What to do
Monitor muscle strength and symptoms and adjust pyridostigmine if control worsens. Consider a less anticholinergic antidepressant.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Amitriptyline and Pyridostigmine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Pyridostigmine
Frequently asked questions
Can I take Amitriptyline with Pyridostigmine?
MediHelp rates the interaction as moderate. Amitriptyline and Pyridostigmine 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's anticholinergic effects oppose the cholinergic action of pyridostigmine and may weaken its effect in myasthenia gravis. The magnitude varies between patients.
How serious is the interaction between Amitriptyline and Pyridostigmine?
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 muscle strength and symptoms and adjust pyridostigmine if control worsens. Consider a less anticholinergic antidepressant.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
