Drug interactions
Amitriptyline + Quinupristin / dalfopristin
Severity: Minor
Amitriptyline and Quinupristin / dalfopristin: minor 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
Quinupristin/dalfopristin inhibits CYP3A4, which contributes to amitriptyline metabolism, so tricyclic exposure may rise modestly. This could increase anticholinergic effects, sedation and cardiac conduction effects, particularly in patients with other risk factors.
What this interaction means in plain words
Amitriptyline and Quinupristin / dalfopristin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
Inhibition of CYP3A4-mediated demethylation of amitriptyline by quinupristin/dalfopristin, which is a minor pathway relative to CYP2C19 and CYP2D6.
What to do
Monitor for tricyclic adverse effects such as sedation, anticholinergic symptoms and palpitations during the antibiotic course. Consider an ECG if the patient has cardiac risk factors or is on a high amitriptyline dose.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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
Frequently asked questions
Can I take Amitriptyline with Quinupristin / dalfopristin?
MediHelp rates the interaction as minor. Amitriptyline and Quinupristin / dalfopristin have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Quinupristin/dalfopristin inhibits CYP3A4, which contributes to amitriptyline metabolism, so tricyclic exposure may rise modestly. This could increase anticholinergic effects, sedation and cardiac conduction effects, particularly in patients with other risk factors.
How serious is the interaction between Amitriptyline and Quinupristin / dalfopristin?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for tricyclic adverse effects such as sedation, anticholinergic symptoms and palpitations during the antibiotic course. Consider an ECG if the patient has cardiac risk factors or is on a high amitriptyline dose.
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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