Drug interactions
Dextroamphetamine + Protriptyline
Severity: Major
Dextroamphetamine and Protriptyline: 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
Protriptyline is a tricyclic with strong noradrenergic reuptake inhibition. With amphetamine it can produce exaggerated cardiovascular stimulation including hypertension, tachycardia and arrhythmia, and amphetamine levels may increase.
What this interaction means in plain words
Dextroamphetamine and Protriptyline 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
Norepinephrine reuptake blockade and CYP2D6 inhibition give additive adrenergic effects and possibly higher amphetamine exposure.
What to do
Avoid if possible. If both are required, use low doses and monitor blood pressure, heart rate, ECG and serotonin toxicity signs.
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 Dextroamphetamine
- Dextroamphetamine + Isocarboxazid Contraindicated
- Dextroamphetamine + Linezolid Contraindicated
- Dextroamphetamine + Methylene blue Contraindicated
- Dextroamphetamine + Phenelzine Contraindicated
- Dextroamphetamine + Rasagiline Contraindicated
- Dextroamphetamine + Safinamide Contraindicated
Frequently asked questions
Can I take Dextroamphetamine with Protriptyline?
MediHelp rates the interaction as major. Dextroamphetamine and Protriptyline 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. Protriptyline is a tricyclic with strong noradrenergic reuptake inhibition. With amphetamine it can produce exaggerated cardiovascular stimulation including hypertension, tachycardia and arrhythmia, and amphetamine levels may increase.
How serious is the interaction between Dextroamphetamine and Protriptyline?
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 if possible. If both are required, use low doses and monitor blood pressure, heart rate, ECG and serotonin toxicity signs.
What other medicines interact with Dextroamphetamine?
MediHelp also lists interactions of Dextroamphetamine with, for example, Isocarboxazid, Linezolid, Methylene blue. The full list is on the Dextroamphetamine page.
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