substrates, if clinically indicated.salmeterolchlordiazepoxide increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.SAMeamitriptyline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.saquinavirsaquinavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.sarecyclinesarecycline will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors.scopolaminescopolamine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.scullcapchlordiazepoxide and scullcap both increase sedation. Use Caution/Monitor.amitriptyline and scullcap both increase sedation. Use Caution/Monitor.secobarbitalsecobarbital will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May also enhance CNS depressant effect of chlordiazepoxidesecobarbital will decrease the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.secobarbital and amitriptyline both increase sedation. Use Caution/Monitor.secobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.selpercatinibselpercatinib increases toxicity of amitriptyline by QTc interval. Use Caution/Monitor.sevofluranesevoflurane and chlordiazepoxide both increase sedation. Use Caution/Monitor.sertralinesertraline and amitriptyline both increase QTc interval. Use Caution/Monitor.sevofluranesevoflurane and amitriptyline both increase sedation. Use Caution/Monitor.sevoflurane and amitriptyline both increase QTc interval. Use Caution/Monitor.shepherd's purseamitriptyline and shepherd's purse both increase sedation. Use Caution/Monitor.chlordiazepoxide and shepherd's purse both increase sedation. Use Caution/Monitor.simvastatinsimvastatin will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.stiripentolstiripentol, chlordiazepoxide. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.stiripentol, chlordiazepoxide. 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.sirolimussirolimus will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.sodium sulfate/?magnesium sulfate/potassium chloridesodium sulfate/?magnesium sulfate/potassium chloride increases effects of amitriptyline 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 glycolamitriptyline, 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 amitriptyline 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 amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.solifenacin and amitriptyline both increase QTc interval. Use Caution/Monitor.sorafenibsorafenib and amitriptyline both increase QTc interval. Use Caution/Monitor.St John's WortSt John's Wort will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.St John's Wort will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.stiripentolstiripentol, amitriptyline. 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 amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.sufentanilchlordiazepoxide and sufentanil both increase sedation. Use Caution/Monitor.sufentanil and amitriptyline both increase sedation. Use Caution/Monitor.sufentanil SLsufentanil SL, amitriptyline. 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.suvorexantsuvorexant and chlordiazepoxide both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessarysulfamethoxazoleamitriptyline and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.sumatriptansumatriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.sumatriptan intranasalsumatriptan intranasal and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.suvorexantsuvorexant and amitriptyline both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessarytacrolimustacrolimus will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.tapentadolchlordiazepoxide and tapentadol both increase sedation. Use Caution/Monitor.amitriptyline and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.tapentadol and amitriptyline both increase sedation. Use Caution/Monitor.tazemetostattazemetostat will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.telavancinamitriptyline and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.tecovirimattecovirimat will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.teduglutideteduglutide increases levels of chlordiazepoxide by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.temazepamchlordiazepoxide and temazepam both increase sedation. Use Caution/Monitor.temazepam and amitriptyline both increase sedation. Use Caution/Monitor.terbinafineterbinafine will increase the level or effect of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.terbinafine will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.terbutalinechlordiazepoxide increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.teriflunomideteriflunomide decreases levels of amitriptyline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.thioridazinechlordiazepoxide and thioridazine both increase sedation. Use Caution/Monitor.tetrabenazinetetrabenazine and amitriptyline both increase QTc interval. Use Caution/Monitor.thioridazinethioridazine and amitriptyline both increase sedation. Use Caution/Monitor.thiothixenechlordiazepoxide and thiothixene both increase sedation. Use Caution/Monitor.thiothixene and amitriptyline both increase sedation. Use Caution/Monitor.thyroid desiccatedthyroid desiccated increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.tipranavirtipranavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.tiotropiumtiotropium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.tolterodinetolterodine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.tolvaptantolvaptan will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.topiramateamitriptyline and topiramate both increase sedation. Modify Therapy/Monitor Closely.chlordiazepoxide and topiramate both increase sedation. Modify Therapy/Monitor Closely.topiramate increases toxicity of amitriptyline by unspecified interaction mechanism. Use Caution/Monitor. Amitriptyline levels may increase; adjust dose based on clinical response and not on basis of plasma levels.tramadolchlordiazepoxide and tramadol both increase sedation. Use Caution/Monitor.amitriptyline and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.tramadol and amitriptyline both increase sedation. Use Caution/Monitor.trazodoneamitriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.chlordiazepoxide and trazodone both increase sedation. Use Caution/Monitor.trazodone will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.amitriptyline and trazodone both increase sedation. Use Caution/Monitor.triazolamchlordiazepoxide and triazolam both increase sedation. Use Caution/Monitor.triazolam and amitriptyline both increase sedation. Use Caution/Monitor.triclofoschlordiazepoxide and triclofos both increase sedation. Use Caution/Monitor.triclofos and amitriptyline both increase sedation. Use Caution/Monitor.trifluoperazinechlordiazepoxide and trifluoperazine both increase sedation. Use Caution/Monitor.trifluoperazine and amitriptyline both increase sedation. Use Caution/Monitor.trihexyphenidyltrihexyphenidyl and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.trimipraminechlordiazepoxide and trimipramine both increase sedation. Use Caution/Monitor.trimethoprimamitriptyline and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.trimipramineamitriptyline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.amitriptyline and trimipramine both increase sedation. Use Caution/Monitor.triprolidinetriprolidine and amitriptyline both increase sedation. Use Caution/Monitor.triprolidine and chlordiazepoxide both increase sedation. Use Caution/Monitor.tropisetronamitriptyline and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.voriconazolevoriconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.trospium chloridetrospium chloride and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.tucatinibtucatinib will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.valbenazinevalbenazine and amitriptyline both increase QTc interval. Use Caution/Monitor.valerianvalerian and amitriptyline both increase sedation. Use Caution/Monitor.vecuroniumvecuronium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.venlafaxineamitriptyline and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.verapamilverapamil will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. The frequency and severity of amitriptyline adverse effects (sedation, anticholinergic effects and orthostatic hypotension) may be increased. Cardiac dysrhythmic effects may be additive. voclosporinvoclosporin, amitriptyline. Either increases effects of the other by QTc interval. Use Caution/Monitor.voriconazolevoriconazole will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.amitriptyline and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.warfarinamitriptyline increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.xylometazolinechlordiazepoxide increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.yohimbineamitriptyline increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlordiazepoxide increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziconotideamitriptyline and ziconotide both increase sedation. Use Caution/Monitor.chlordiazepoxide and ziconotide both increase sedation. Use Caution/Monitor.ziprasidonechlordiazepoxide and ziprasidone both increase sedation. Use Caution/Monitor.ziprasidone and amitriptyline both increase sedation. Use Caution/Monitor.zolmitriptanzolmitriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.zotepinechlordiazepoxide and zotepine both increase sedation. Use Caution/Monitor.Minor (125)acarboseamitriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.acetazolamideacetazolamide will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.anastrozoleanastrozole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.armodafinilarmodafinil will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.artemether/lumefantrineartemether/lumefantrine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.atropineamitriptyline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.atropine IV/IMamitriptyline increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.bazedoxifene/conjugated estrogensbazedoxifene/conjugated estrogens, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.bortezomibbortezomib will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.bosentanbosentan will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.brimonidineamitriptyline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.brimonidine increases effects of chlordiazepoxide by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.budesonidebudesonide will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ciprofloxacinciprofloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.butabarbitalbutabarbital, amitriptyline. 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, amitriptyline. 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 amitriptyline by increasing metabolism. Minor/Significance Unknown.chlorpromazineamitriptyline, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amitriptyline, chlorpromazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.chlorpropamideamitriptyline increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.clotrimazoleclotrimazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.conjugated estrogensconjugated estrogens, amitriptyline. 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, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.cortisonecortisone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.cyclophosphamidecyclophosphamide will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.desfluranedesflurane, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.dexamethasonedexamethasone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.dexmethylphenidatedexmethylphenidate increases effects of amitriptyline by decreasing metabolism. Minor/Significance Unknown.DHEA, herbalDHEA, herbal will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.disulfiramdisulfiram increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.eslicarbazepine acetateeslicarbazepine acetate will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.esomeprazoleesomeprazole will increase the level or effect of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.estradiolestradiol, amitriptyline. 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, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA