Drug interactions
Amitriptyline + Sufentanil sl
Severity: Major
Amitriptyline and Sufentanil sl: major interaction.
Last updated Sources: US FDA label
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
Sublingual sufentanil combined with amitriptyline carries additive sedation and respiratory depression risk. Serotonin syndrome is also possible because both drugs affect serotonergic transmission.
What this interaction means in plain words
Amitriptyline and Sufentanil sl can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS and respiratory depression, plus additive serotonergic activity.
What to do
Monitor for sedation, respiratory depression, and signs of serotonin syndrome (agitation, tremor, hyperthermia, clonus), especially at initiation and dose changes. Use the lowest effective doses.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Sufentanil sl?
MediHelp rates the interaction as major. Amitriptyline and Sufentanil sl can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Sublingual sufentanil combined with amitriptyline carries additive sedation and respiratory depression risk. Serotonin syndrome is also possible because both drugs affect serotonergic transmission.
How serious is the interaction between Amitriptyline and Sufentanil sl?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation, respiratory depression, and signs of serotonin syndrome (agitation, tremor, hyperthermia, clonus), especially at initiation and dose changes. Use the lowest effective doses.
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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