Drug interactions
Dosulepin + Escitalopram
Severity: Major
Dosulepin 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
Both drugs enhance serotonergic transmission, so serotonin syndrome is possible. Dosulepin is also a tricyclic with QT and cardiac conduction effects, and escitalopram may raise tricyclic levels slightly.
What this interaction means in plain words
Dosulepin 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.
Dosulepin belongs to Central Nervous System; Escitalopram belongs to Central Nervous System.
Why it happens
Additive serotonin reuptake inhibition, with additive QT effects and possible CYP2D6-mediated increases in tricyclic exposure.
What to do
Avoid the combination where possible. If it is unavoidable, use low doses, monitor ECG and for signs of serotonin toxicity, and consider tricyclic levels or dose reduction.
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
Other interactions of Dosulepin
- Dosulepin + Isocarboxazid Contraindicated
- Dosulepin + Phenelzine Contraindicated
- Dosulepin + Thioridazine Contraindicated
- Dosulepin + Tranylcypromine Contraindicated
- Amitriptyline + Dosulepin Major
- Buprenorphine + Dosulepin Major
Frequently asked questions
Can I take Dosulepin with Escitalopram?
MediHelp rates the interaction as major. Dosulepin 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. Both drugs enhance serotonergic transmission, so serotonin syndrome is possible. Dosulepin is also a tricyclic with QT and cardiac conduction effects, and escitalopram may raise tricyclic levels slightly.
How serious is the interaction between Dosulepin 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 the combination where possible. If it is unavoidable, use low doses, monitor ECG and for signs of serotonin toxicity, and consider tricyclic levels or dose reduction.
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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