Closely.risperidone and protriptyline both increase sedation. Use Caution/Monitor.rivastigminerivastigmine increases and protriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.rizatriptanrizatriptan and protriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.rocuroniumrocuronium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.rolapitantrolapitant will increase the level or effect of protriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.romidepsinprotriptyline and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.salmeterolprotriptyline increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.SAMeprotriptyline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.scopolaminescopolamine and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.scullcapprotriptyline and scullcap both increase sedation. Use Caution/Monitor.secobarbitalsecobarbital and protriptyline both increase sedation. Use Caution/Monitor.selpercatinibselpercatinib increases toxicity of protriptyline by QTc interval. Use Caution/Monitor.sevofluranesevoflurane and protriptyline both increase sedation. Use Caution/Monitor.sevoflurane and protriptyline both increase QTc interval. Use Caution/Monitor.shepherd's purseprotriptyline and shepherd's purse both increase sedation. Use Caution/Monitor.sodium sulfate/?magnesium sulfate/potassium chloridesodium sulfate/?magnesium sulfate/potassium chloride increases effects of protriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycolprotriptyline, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.sodium sulfate/potassium sulfate/magnesium sulfatesodium sulfate/potassium sulfate/magnesium sulfate increases effects of protriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.solifenacinsolifenacin and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.solifenacin and protriptyline both increase QTc interval. Use Caution/Monitor.sorafenibsorafenib and protriptyline both increase QTc interval. Use Caution/Monitor.stiripentolstiripentol, protriptyline. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.succinylcholinesuccinylcholine increases and protriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.sufentanilsufentanil and protriptyline both increase sedation. Use Caution/Monitor.sufentanil SLsufentanil SL, protriptyline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.sulfamethoxazoleprotriptyline and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.sumatriptansumatriptan and protriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.sumatriptan intranasalsumatriptan intranasal and protriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.suvorexantsuvorexant and protriptyline both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessarytapentadoltapentadol and protriptyline both increase sedation. Use Caution/Monitor.protriptyline and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.telavancinprotriptyline and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.temazepamtemazepam and protriptyline both increase sedation. Use Caution/Monitor.terbinafineterbinafine will increase the level or effect of protriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.terbutalineprotriptyline increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tetrabenazinetetrabenazine and protriptyline both increase QTc interval. Use Caution/Monitor.thioridazinethioridazine and protriptyline both increase sedation. Use Caution/Monitor.thiothixenethiothixene and protriptyline both increase sedation. Use Caution/Monitor.thyroid desiccatedthyroid desiccated increases effects of protriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.tiotropiumtiotropium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.tolterodinetolterodine and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.topiramateprotriptyline and topiramate both increase sedation. Modify Therapy/Monitor Closely.tramadoltramadol and protriptyline both increase sedation. Use Caution/Monitor.protriptyline and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.trazodoneprotriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.protriptyline and trazodone both increase sedation. Use Caution/Monitor.triazolamtriazolam and protriptyline both increase sedation. Use Caution/Monitor.triclofostriclofos and protriptyline both increase sedation. Use Caution/Monitor.trifluoperazinetrifluoperazine and protriptyline both increase sedation. Use Caution/Monitor.trihexyphenidyltrihexyphenidyl and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.trimethoprimprotriptyline and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.trimipramineprotriptyline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.protriptyline and trimipramine both increase sedation. Use Caution/Monitor.triprolidinetriprolidine and protriptyline both increase sedation. Use Caution/Monitor.tropisetronprotriptyline and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.trospium chloridetrospium chloride and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.valbenazinevalbenazine and protriptyline both increase QTc interval. Use Caution/Monitor.valerianvalerian and protriptyline both increase sedation. Use Caution/Monitor.vecuroniumvecuronium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.venlafaxineprotriptyline and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.voclosporinvoclosporin, protriptyline. Either increases effects of the other by QTc interval. Use Caution/Monitor.voriconazoleprotriptyline and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.xylometazolineprotriptyline increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.yohimbineprotriptyline increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziconotideprotriptyline and ziconotide both increase sedation. Use Caution/Monitor.ziprasidoneziprasidone and protriptyline both increase sedation. Use Caution/Monitor.zolmitriptanzolmitriptan and protriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (71)acarboseprotriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.amobarbitalamobarbital, protriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.atropineprotriptyline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.atropine IV/IMprotriptyline increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.bazedoxifene/conjugated estrogensbazedoxifene/conjugated estrogens, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.brimonidineprotriptyline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.butabarbitalbutabarbital, protriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.butalbitalbutalbital, protriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.carbamazepinecarbamazepine decreases levels of protriptyline by increasing metabolism. Minor/Significance Unknown.chloroquinechloroquine increases toxicity of protriptyline by QTc interval. Minor/Significance Unknown.chlorpromazineprotriptyline, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.protriptyline, chlorpromazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.chlorpropamideprotriptyline increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.conjugated estrogensconjugated estrogens, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.conjugated estrogens, vaginalconjugated estrogens, vaginal, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.desfluranedesflurane, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.dexmethylphenidatedexmethylphenidate increases effects of protriptyline by decreasing metabolism. Minor/Significance Unknown.estradiolestradiol, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.estrogens conjugated syntheticestrogens conjugated synthetic, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.estrogens esterifiedestrogens esterified, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens may inhibit hepatic metabolism of tricyclic antidepressants. However, interactions are not common.estropipateestropipate, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.ethinylestradiolethinylestradiol, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Oxidative metabolism of TCAs may be decreased by ethinyl estradiol. Increased antidepressant serum concentrations may occur. Potential for increased TCA adverse effects.etomidateetomidate, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.eucalyptusprotriptyline and eucalyptus both increase sedation. Minor/Significance Unknown.fluphenazineprotriptyline, fluphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.protriptyline, fluphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.glimepirideprotriptyline increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.glipizideprotriptyline increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.glyburideprotriptyline increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.hydroxyprogesterone caproate (DSC)hydroxyprogesterone caproate (DSC), protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.insulin aspartprotriptyline increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.insulin detemirprotriptyline increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.insulin glargineprotriptyline increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.insulin glulisineprotriptyline increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.insulin lisproprotriptyline increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.insulin NPHprotriptyline increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.insulin regular humanprotriptyline increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.isoproterenolisoproterenol, protriptyline. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.ketamineketamine, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.lithiumlithium, protriptyline. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.mestranolmestranol, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.metforminprotriptyline increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.miglitolprotriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.nateglinideprotriptyline increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.panax ginsengpanax ginseng increases effects of protriptyline by pharmacodynamic synergism. Minor/Significance Unknown.pentobarbitalpentobarbital, protriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.perphenazineprotriptyline, perphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.protriptyline, perphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.phenobarbitalphenobarbital, protriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.pioglitazoneprotriptyline increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.pleurisy rootpleurisy root decreases effects of protriptyline by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.primidoneprimidone, protriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.prochlorperazineprotriptyline, prochlorperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.protriptyline, prochlorperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.progesterone micronizedprogesterone micronized, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.promazineprotriptyline, promazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.protriptyline, promazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.promethazineprotriptyline, promethazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.protriptyline, promethazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.propofolpropofol, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.repaglinideprotriptyline increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.rosiglitazoneprotriptyline increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.sageprotriptyline and sage both increase sedation. Minor/Significance Unknown.saxagliptinprotriptyline increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.secobarbitalsecobarbital, protriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.serdexmethylphenidate/dexmethylphenidateserdexmethylphenidate/dexmethylphenidate increases effects of protriptyline by decreasing metabolism. Minor/Significance Unknown.sevofluranesevoflurane, protriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.sitagliptinprotriptyline increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.sulfamethoxazolesulfamethoxazole decreases levels of protriptyline by unspecified interaction mechanism. Minor/Significance Unknown.thioridazineprotriptyline, thioridazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.protriptyline, thioridazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.tolazamideprotriptyline increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.tolbutamideprotriptyline increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.trifluoperazineprotriptyline, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.protriptyline, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.vasopressinprotriptyline increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.verapamilverapamil increases levels of protriptyline by decreasing metabolism. Minor/Significance Unknown.vildagliptinprotriptyline increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.zolpidemzolpidem, protriptyline. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.5-HTPMonitor Closely (1)protriptyline and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abirateroneMonitor Closely (1)abiraterone increases levels of protriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates