Drug interactions
Amitriptyline + Terbinafine
Severity: Moderate
Amitriptyline and Terbinafine: 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
Terbinafine is a strong CYP2D6 inhibitor and can raise concentrations of amitriptyline and its active metabolite nortriptyline. This may increase anticholinergic effects, sedation and cardiac conduction or QT effects.
What this interaction means in plain words
Amitriptyline and Terbinafine 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; Terbinafine belongs to Anti Fungals.
Why it happens
Terbinafine inhibits CYP2D6, reducing hydroxylation of amitriptyline and nortriptyline.
What to do
Monitor for tricyclic toxicity and consider an ECG and lower amitriptyline dose; check drug levels if 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 Terbinafine
- Terbinafine + Thioridazine Contraindicated
- Desipramine + Terbinafine Major
- Eliglustat + Terbinafine Major
- Flecainide + Terbinafine Major
- Imipramine + Terbinafine Major
- Maprotiline + Terbinafine 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 Terbinafine?
MediHelp rates the interaction as moderate. Amitriptyline and Terbinafine 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. Terbinafine is a strong CYP2D6 inhibitor and can raise concentrations of amitriptyline and its active metabolite nortriptyline. This may increase anticholinergic effects, sedation and cardiac conduction or QT effects.
How serious is the interaction between Amitriptyline and Terbinafine?
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 tricyclic toxicity and consider an ECG and lower amitriptyline dose; check drug levels if available.
What other medicines interact with Terbinafine?
MediHelp also lists interactions of Terbinafine with, for example, Thioridazine, Desipramine, Eliglustat. The full list is on the Terbinafine page.
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