Drug interactions
Protriptyline + Vortioxetine
Severity: Major
Protriptyline and Vortioxetine: 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
Combining vortioxetine with a tricyclic antidepressant increases serotonergic load and the risk of serotonin syndrome. Vortioxetine may also raise protriptyline levels through CYP2D6 competition, and protriptyline adds anticholinergic and cardiac effects.
What this interaction means in plain words
Protriptyline and Vortioxetine 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
Additive serotonergic effects, with possible pharmacokinetic interaction at CYP2D6.
What to do
Avoid the combination where possible. If both are needed, use low doses, monitor for serotonin syndrome and consider ECG monitoring and tricyclic levels.
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 Vortioxetine
- Isocarboxazid + Vortioxetine Contraindicated
- Linezolid + Vortioxetine Contraindicated
- Methylene blue + Vortioxetine Contraindicated
- Phenelzine + Vortioxetine Contraindicated
- Rasagiline + Vortioxetine Contraindicated
- Selegiline transdermal + Vortioxetine Contraindicated
Frequently asked questions
Can I take Protriptyline with Vortioxetine?
MediHelp rates the interaction as major. Protriptyline and Vortioxetine 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. Combining vortioxetine with a tricyclic antidepressant increases serotonergic load and the risk of serotonin syndrome. Vortioxetine may also raise protriptyline levels through CYP2D6 competition, and protriptyline adds anticholinergic and cardiac effects.
How serious is the interaction between Protriptyline and Vortioxetine?
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 both are needed, use low doses, monitor for serotonin syndrome and consider ECG monitoring and tricyclic levels.
What other medicines interact with Vortioxetine?
MediHelp also lists interactions of Vortioxetine with, for example, Isocarboxazid, Linezolid, Methylene blue. The full list is on the Vortioxetine page.
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