Drug interactions
Atomoxetine + Terbinafine
Severity: Moderate
Atomoxetine 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 inhibits CYP2D6, the main enzyme clearing atomoxetine, and can substantially raise atomoxetine exposure. This resembles the situation in CYP2D6 poor metabolizers, with more adverse effects such as increased heart rate, blood pressure, insomnia and nausea.
What this interaction means in plain words
Atomoxetine 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.
Atomoxetine belongs to Central Nervous System; Terbinafine belongs to Anti Fungals.
Why it happens
CYP2D6 inhibition by terbinafine reduces atomoxetine metabolism.
What to do
Start atomoxetine at a lower dose and titrate slowly, monitoring heart rate and blood pressure.
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 Atomoxetine
- Atomoxetine + Isocarboxazid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Atomoxetine + Rasagiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Atomoxetine with Terbinafine?
MediHelp rates the interaction as moderate. Atomoxetine 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 inhibits CYP2D6, the main enzyme clearing atomoxetine, and can substantially raise atomoxetine exposure. This resembles the situation in CYP2D6 poor metabolizers, with more adverse effects such as increased heart rate, blood pressure, insomnia and nausea.
How serious is the interaction between Atomoxetine 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: Start atomoxetine at a lower dose and titrate slowly, monitoring heart rate and blood pressure.
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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