Drug interactions
Amoxapine + Escitalopram
Severity: Major
Amoxapine and Escitalopram: 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
Amoxapine inhibits serotonin and norepinephrine reuptake, so combined use with escitalopram may cause serotonin syndrome. Both agents can also affect cardiac conduction and lower the seizure threshold.
What this interaction means in plain words
Amoxapine and Escitalopram 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 serotonergic effects, with possible CYP2D6 inhibition by escitalopram raising amoxapine levels.
What to do
Avoid combining the two if possible. If used, start at low doses, monitor for serotonin toxicity and obtain an ECG.
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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Amoxapine with Escitalopram?
MediHelp rates the interaction as major. Amoxapine and Escitalopram 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. Amoxapine inhibits serotonin and norepinephrine reuptake, so combined use with escitalopram may cause serotonin syndrome. Both agents can also affect cardiac conduction and lower the seizure threshold.
How serious is the interaction between Amoxapine and Escitalopram?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining the two if possible. If used, start at low doses, monitor for serotonin toxicity and obtain an ECG.
What other medicines interact with Escitalopram?
MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.
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