相互作用
Amitriptyline + Primidone
重症度: 重大
Amitriptyline and Primidone: major interaction.
最終更新日
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概要
Primidone is metabolized to phenobarbital, which induces hepatic enzymes and may reduce amitriptyline levels. Additive sedation is also likely, and tricyclics may lower the seizure threshold.
この相互作用をわかりやすく説明すると
Amitriptyline and Primidone 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.
Amitriptyline belongs to Central Nervous System; Primidone belongs to Central Nervous System.
なぜ起こるのか
Enzyme induction (CYP3A4 and CYP2C19) by primidone and its phenobarbital metabolite, plus additive CNS depression.
対処法
Monitor for loss of antidepressant effect, sedation, and seizure control, and adjust amitriptyline dose by response or levels. Reassess dosing if primidone is stopped.
薬剤師に尋ねること
- 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?
Pro+会員向け
ページ全体を見る
アカウントを作成してPro+トライアルを始めると、AmitriptylineとPrimidoneの臨床対応の詳細なアドバイス、追加の注記、エビデンスの詳細、処方全体を対象とした相互作用チェッカーを利用できます。
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
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Amitriptylineのその他の相互作用
Primidoneのその他の相互作用
よくある質問
Can I take Amitriptyline with Primidone?
MediHelp rates the interaction as major. Amitriptyline and Primidone 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. Primidone is metabolized to phenobarbital, which induces hepatic enzymes and may reduce amitriptyline levels. Additive sedation is also likely, and tricyclics may lower the seizure threshold.
How serious is the interaction between Amitriptyline and Primidone?
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 for loss of antidepressant effect, sedation, and seizure control, and adjust amitriptyline dose by response or levels. Reassess dosing if primidone is stopped.
What other medicines interact with Amitriptyline?
MediHelp also lists interactions of Amitriptyline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Amitriptyline page.
完全なモノグラフ、用量、相互作用チェッカーはMediHelpアプリで
MediHelpアプリで、完全なリファレンスを開き、複数薬剤の相互作用をチェックし、用量ツールを利用できます。