Drug interactions
Amitriptyline + Remimazolam
Severity: Moderate
Amitriptyline and Remimazolam: 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
Combining remimazolam with amitriptyline adds sedative effects and can deepen sedation and depress breathing. Profound sedation, respiratory depression and loss of consciousness are possible, especially in older or frail patients.
What this interaction means in plain words
Amitriptyline and Remimazolam 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; Remimazolam belongs to Central Nervous System.
Why it happens
Additive central nervous system depression from benzodiazepine GABA-A potentiation and the sedative antihistaminic and anticholinergic effects of amitriptyline.
What to do
Titrate remimazolam carefully to the lowest effective dose and monitor oxygen saturation, respiratory rate and level of consciousness continuously through sedation and recovery. Make sure airway support and resuscitation equipment are available.
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 Remimazolam
Frequently asked questions
Can I take Amitriptyline with Remimazolam?
MediHelp rates the interaction as moderate. Amitriptyline and Remimazolam 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. Combining remimazolam with amitriptyline adds sedative effects and can deepen sedation and depress breathing. Profound sedation, respiratory depression and loss of consciousness are possible, especially in older or frail patients.
How serious is the interaction between Amitriptyline and Remimazolam?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate remimazolam carefully to the lowest effective dose and monitor oxygen saturation, respiratory rate and level of consciousness continuously through sedation and recovery. Make sure airway support and resuscitation equipment are available.
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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