Drug interactions
Protriptyline + Umeclidinium-vilanterol
Severity: Major
Protriptyline and Umeclidinium-vilanterol: 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
Tricyclic antidepressants can potentiate the cardiovascular effects of beta-2 agonists such as vilanterol, leading to tachycardia, hypertension and arrhythmia. Protriptyline also prolongs the QT interval and has anticholinergic activity that may add to umeclidinium.
What this interaction means in plain words
Protriptyline 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.
Why it happens
Tricyclic inhibition of norepinephrine reuptake and additive QT prolongation potentiate beta-agonist cardiovascular effects, with additive anticholinergic effects.
What to do
Avoid the combination where possible, particularly within 2 weeks of starting or stopping the tricyclic. If used together, monitor heart rate, blood pressure and ECG, and watch for anticholinergic effects.
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 Umeclidinium-vilanterol
Frequently asked questions
Can I take Protriptyline with Umeclidinium-vilanterol?
MediHelp rates the interaction as major. Protriptyline 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 can potentiate the cardiovascular effects of beta-2 agonists such as vilanterol, leading to tachycardia, hypertension and arrhythmia. Protriptyline also prolongs the QT interval and has anticholinergic activity that may add to umeclidinium.
How serious is the interaction between Protriptyline 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: Avoid the combination where possible, particularly within 2 weeks of starting or stopping the tricyclic. If used together, monitor heart rate, blood pressure and ECG, and watch for anticholinergic effects.
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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