Drug interactions
Amitriptyline + Same
Severity: Moderate
Amitriptyline and Same: 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
S-adenosylmethionine (SAMe) has serotonergic activity and may add to the serotonin-raising effect of amitriptyline. Serotonin syndrome has been reported with this type of combination, though mainly as isolated reports.
What this interaction means in plain words
Amitriptyline and Same 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.
Why it happens
Additive serotonergic effects, with SAMe possibly increasing serotonin turnover while amitriptyline inhibits serotonin reuptake.
What to do
Avoid starting SAMe without clinician review and counsel the patient about symptoms of serotonin toxicity such as agitation, tremor, sweating and fever. Stop SAMe if such symptoms develop.
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
Frequently asked questions
Can I take Amitriptyline with Same?
MediHelp rates the interaction as moderate. Amitriptyline and Same 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. S-adenosylmethionine (SAMe) has serotonergic activity and may add to the serotonin-raising effect of amitriptyline. Serotonin syndrome has been reported with this type of combination, though mainly as isolated reports.
How serious is the interaction between Amitriptyline and Same?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid starting SAMe without clinician review and counsel the patient about symptoms of serotonin toxicity such as agitation, tremor, sweating and fever. Stop SAMe if such symptoms develop.
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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