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Лекарственные взаимодействия

Amitriptyline + Cocaine

Тяжесть: Тяжёлое

Amitriptyline and Cocaine: major interaction.

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Кратко

Cocaine blocks reuptake of norepinephrine, dopamine and serotonin, and tricyclics also block norepinephrine and serotonin reuptake. Combined use can cause exaggerated sympathomimetic effects, arrhythmias, hypertension and seizures. With topical cocaine, systemic absorption is usually small, but the effect can be significant with mucosal application at high doses or in abuse.

Что означает это взаимодействие простыми словами

Amitriptyline and Cocaine 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; Cocaine belongs to Central Nervous System.

Уровень доказательности: Moderate

Почему это происходит

Additive monoamine reuptake inhibition with potentiated adrenergic effects and additive proarrhythmic sodium channel blockade.

Что делать

Avoid cocaine, including recreational use, in patients taking amitriptyline. For medical topical use, use the lowest dose and monitor blood pressure, heart rhythm and ECG.

О чём спросить фармацевта

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Частые вопросы

Can I take Amitriptyline with Cocaine?

MediHelp rates the interaction as major. Amitriptyline and Cocaine 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. Cocaine blocks reuptake of norepinephrine, dopamine and serotonin, and tricyclics also block norepinephrine and serotonin reuptake. Combined use can cause exaggerated sympathomimetic effects, arrhythmias, hypertension and seizures. With topical cocaine, systemic absorption is usually small, but the effect can be significant with mucosal application at high doses or in abuse.

How serious is the interaction between Amitriptyline and Cocaine?

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 cocaine, including recreational use, in patients taking amitriptyline. For medical topical use, use the lowest dose and monitor blood pressure, heart rhythm and ECG.

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.

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