Drug interactions
Amitriptyline + Sertraline
Severity: Moderate
Amitriptyline and Sertraline: 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
Both drugs enhance serotonergic transmission, so combined use can cause serotonin syndrome. Sertraline may also modestly raise amitriptyline levels through CYP2D6 inhibition, adding to tricyclic toxicity.
What this interaction means in plain words
Amitriptyline and Sertraline 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; Sertraline belongs to Central Nervous System.
Why it happens
Additive serotonin reuptake inhibition with mild to moderate CYP2D6 inhibition by sertraline.
What to do
Use the lowest effective doses and monitor for serotonin syndrome and tricyclic adverse effects. Consider checking amitriptyline levels and an ECG when sertraline doses are higher.
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 Sertraline
- Isocarboxazid + Sertraline Contraindicated
- Methylene blue + Sertraline Contraindicated
- Phenelzine + Sertraline Contraindicated
- Pimozide + Sertraline Contraindicated
- Selegiline transdermal + Sertraline Contraindicated
- Selegiline + Sertraline Contraindicated
Frequently asked questions
Can I take Amitriptyline with Sertraline?
MediHelp rates the interaction as moderate. Amitriptyline and Sertraline 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. Both drugs enhance serotonergic transmission, so combined use can cause serotonin syndrome. Sertraline may also modestly raise amitriptyline levels through CYP2D6 inhibition, adding to tricyclic toxicity.
How serious is the interaction between Amitriptyline and Sertraline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor for serotonin syndrome and tricyclic adverse effects. Consider checking amitriptyline levels and an ECG when sertraline doses are higher.
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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