Drug interactions
Doxepin + Umeclidinium-vilanterol
Severity: Major
Doxepin and Umeclidinium-vilanterol: major 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
Tricyclic antidepressants such as doxepin can potentiate the cardiovascular effects of beta-2 agonists, causing tachycardia, palpitations, blood pressure changes and arrhythmias. Doxepin also has anticholinergic properties that add to those of umeclidinium and can prolong the QT interval at higher doses.
What this interaction means in plain words
Doxepin and Umeclidinium-vilanterol 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.
Doxepin belongs to Dermatology; Umeclidinium-vilanterol belongs to Respiratory.
Why it happens
Tricyclics inhibit norepinephrine reuptake and potentiate the vascular and cardiac effects of beta-agonists, with additive antimuscarinic and QT effects.
What to do
Monitor heart rate, blood pressure and ECG when the combination is used, and use the lowest doxepin dose needed. Choose an alternative antidepressant if cardiovascular symptoms occur.
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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Other interactions of Umeclidinium-vilanterol
Other interactions of Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Doxepin with Umeclidinium-vilanterol?
MediHelp rates the interaction as major. Doxepin and Umeclidinium-vilanterol 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. Tricyclic antidepressants such as doxepin can potentiate the cardiovascular effects of beta-2 agonists, causing tachycardia, palpitations, blood pressure changes and arrhythmias. Doxepin also has anticholinergic properties that add to those of umeclidinium and can prolong the QT interval at higher doses.
How serious is the interaction between Doxepin and Umeclidinium-vilanterol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate, blood pressure and ECG when the combination is used, and use the lowest doxepin dose needed. Choose an alternative antidepressant if cardiovascular symptoms occur.
What other medicines interact with Umeclidinium-vilanterol?
MediHelp also lists interactions of Umeclidinium-vilanterol with, for example, Aclidinium, Amiodarone, Amitriptyline. The full list is on the Umeclidinium-vilanterol page.
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