Drug interactions
Amitriptyline + Rolapitant
Severity: Moderate
Amitriptyline and Rolapitant: 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
Rolapitant inhibits CYP2D6 for a prolonged period, which can raise amitriptyline levels. This may increase anticholinergic effects, sedation and QT or arrhythmia risk.
What this interaction means in plain words
Amitriptyline and Rolapitant 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; Rolapitant belongs to Gastrointestinal Tract.
Why it happens
Rolapitant inhibits CYP2D6, reducing metabolism of amitriptyline and its active metabolites.
What to do
Monitor for anticholinergic and cardiac effects, and consider ECG monitoring and dose reduction. Remember the inhibition persists for at least 28 days after rolapitant.
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 Rolapitant
- Pimozide + Rolapitant Contraindicated
- Rolapitant + Thioridazine Contraindicated
- Atomoxetine + Rolapitant Major
- Deutetrabenazine + Rolapitant Major
- Eliglustat + Rolapitant Major
- Flecainide + Rolapitant Major
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 Rolapitant?
MediHelp rates the interaction as moderate. Amitriptyline and Rolapitant 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. Rolapitant inhibits CYP2D6 for a prolonged period, which can raise amitriptyline levels. This may increase anticholinergic effects, sedation and QT or arrhythmia risk.
How serious is the interaction between Amitriptyline and Rolapitant?
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 for anticholinergic and cardiac effects, and consider ECG monitoring and dose reduction. Remember the inhibition persists for at least 28 days after rolapitant.
What other medicines interact with Rolapitant?
MediHelp also lists interactions of Rolapitant with, for example, Pimozide, Thioridazine, Atomoxetine. The full list is on the Rolapitant page.
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