and amitriptyline both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).dexamethasoneMinor (1)dexamethasone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine and amitriptyline both increase sedation. Use Caution/Monitor.dexfenfluramineMonitor Closely (2)amitriptyline and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely. amitriptyline increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, dexfenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.dexmedetomidineMonitor Closely (1)dexmedetomidine and amitriptyline both increase sedation. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)amitriptyline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.Minor (1)dexmethylphenidate increases effects of amitriptyline by decreasing metabolism. Minor/Significance Unknown.dextroamphetamineMonitor Closely (3)amitriptyline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor. amitriptyline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely. amitriptyline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.dextroamphetamine transdermalMonitor Closely (1)amitriptyline will increase the level or effect of dextroamphetamine transdermal by pharmacodynamic synergism. Modify Therapy/Monitor Closely. May enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in dextroamphetamine levels in brain; May be potentiate cardiovascular effects. Monitor frequently and adjust or use an alternant based on clinical response.dextromethorphanSerious - Use Alternative (1)amitriptyline and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.dextromoramideMonitor Closely (1)dextromoramide and amitriptyline both increase sedation. Use Caution/Monitor.DHEA, herbalMinor (1)DHEA, herbal will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.diamorphineMonitor Closely (1)diamorphine and amitriptyline both increase sedation. Use Caution/Monitor.diazepamMonitor Closely (1)diazepam and amitriptyline both increase sedation. Use Caution/Monitor.diazepam intranasalMonitor Closely (1)diazepam intranasal, amitriptyline. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.dicyclomineMonitor Closely (1)dicyclomine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.diethylpropionMonitor Closely (1)amitriptyline increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, diethylpropion. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.difelikefalinMonitor Closely (1)difelikefalin and amitriptyline both increase sedation. Use Caution/Monitor.difenoxin hclMonitor Closely (1)difenoxin hcl and amitriptyline both increase sedation. Use Caution/Monitor.dihydroergotamineMonitor Closely (1)amitriptyline and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.dihydroergotamine intranasalMonitor Closely (1)amitriptyline and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.diltiazemMonitor Closely (1)diltiazem will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use with amitriptyline may alter blood pressure control.dimenhydrinateMonitor Closely (1)dimenhydrinate and amitriptyline both increase sedation. Use Caution/Monitor.diphenhydramineMonitor Closely (2)diphenhydramine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely. diphenhydramine and amitriptyline both increase sedation. Use Caution/Monitor.diphenoxylate hclMonitor Closely (1)diphenoxylate hcl and amitriptyline both increase sedation. Use Caution/Monitor.dipipanoneMonitor Closely (1)dipipanone and amitriptyline both increase sedation. Use Caution/Monitor.disopyramideContraindicated (1)amitriptyline and disopyramide both increase QTc interval. Contraindicated.dobutamineMonitor Closely (1)amitriptyline increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, dobutamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.dofetilideMonitor Closely (1)dofetilide increases toxicity of amitriptyline by QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.dolasetronMonitor Closely (1)amitriptyline and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)dolasetron, amitriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.donepezilMonitor Closely (2)donepezil and amitriptyline both increase QTc interval. Use Caution/Monitor. donepezil increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.dopamineMonitor Closely (1)amitriptyline increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, dopamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.dopexamineMonitor Closely (1)amitriptyline increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, dopexamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.dosulepinMonitor Closely (2)amitriptyline and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor. amitriptyline and dosulepin both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)amitriptyline and dosulepin both increase QTc interval. Avoid or Use Alternate Drug. amitriptyline and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.doxepinMonitor Closely (2)amitriptyline and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor. amitriptyline and doxepin both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)amitriptyline and doxepin both increase QTc interval. Avoid or Use Alternate Drug. amitriptyline and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.doxylamineMonitor Closely (1)doxylamine and amitriptyline both increase sedation. Use Caution/Monitor.dronedaroneContraindicated (2)dronedarone will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. dronedarone will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Contraindicated.Serious - Use Alternative (2)amitriptyline and dronedarone both increase QTc interval. Avoid or Use Alternate Drug. dronedarone and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.droperidolMonitor Closely (1)droperidol and amitriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline and droperidol both increase QTc interval. Avoid or Use Alternate Drug.duloxetineSerious - Use Alternative (1)duloxetine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.echothiophate iodideMonitor Closely (1)echothiophate iodide increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.efavirenzMonitor Closely (3)efavirenz will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. efavirenz and amitriptyline both increase QTc interval. Use Caution/Monitor. efavirenz will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.elagolixMonitor Closely (1)elagolix will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.eletriptanMonitor Closely (1)eletriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.eliglustatMonitor Closely (3)eliglustat and amitriptyline both increase QTc interval. Use Caution/Monitor. eliglustat increases levels of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect. eliglustat increases levels of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.elvitegravir/cobicistat/emtricitabine/tenofovir DFMonitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.encorafenibSerious - Use Alternative (1)encorafenib and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.entrectinibMonitor Closely (1)entrectinib and amitriptyline both increase QTc interval. Use Caution/Monitor.ephedrineMonitor Closely (2)amitriptyline increases effects of ephedrine by unknown mechanism. Use Caution/Monitor. amitriptyline increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, ephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.epinephrineMonitor Closely (2)amitriptyline increases effects of epinephrine by unknown mechanism. Use Caution/Monitor. amitriptyline increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)epinephrine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug. amitriptyline, epinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.epinephrine inhaledMonitor Closely (1)amitriptyline and epinephrine inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Tricyclic antidepressants may potentiate epinephrine effect on cardiovascular system.epinephrine racemicMonitor Closely (2)amitriptyline increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor. amitriptyline increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)epinephrine racemic and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug. amitriptyline, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.ergotamineMonitor Closely (1)amitriptyline and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.eribulinMonitor Closely (1)eribulin and amitriptyline both increase QTc interval. Use Caution/Monitor.erythromycin baseSerious - Use Alternative (3)amitriptyline and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug. erythromycin base will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. erythromycin base will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.erythromycin ethylsuccinateSerious - Use Alternative (3)amitriptyline and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug. erythromycin ethylsuccinate will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. erythromycin ethylsuccinate will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.erythromycin lactobionateSerious - Use Alternative (3)amitriptyline and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug. erythromycin lactobionate will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. erythromycin lactobionate will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.erythromycin stearateSerious - Use Alternative (3)amitriptyline and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug. erythromycin stearate will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. erythromycin stearate will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.escitalopramSerious - Use Alternative (2)escitalopram and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug. escitalopram increases toxicity of amitriptyline by QTc interval. Avoid or Use Alternate Drug.esketamine intranasalMonitor Closely (1)esketamine intranasal, amitriptyline. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.eslicarbazepine acetateMonitor Closely (1)eslicarbazepine acetate will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.Minor (1)eslicarbazepine acetate will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.esomeprazoleMonitor Closely (1)esomeprazole will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.estazolamMonitor Closely (1)estazolam and amitriptyline both increase sedation. Use Caution/Monitor.estradiolMinor (1)estradiol, 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 syntheticMinor (1)estrogens conjugated synthetic, 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 esterifiedMinor (1)estrogens esterified, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens may inhibit hepatic metabolism of tricyclic antidepressants. However, interactions are not common.estropipateMinor (1)estropipate, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.ethanolMonitor Closely (1)amitriptyline and ethanol both increase sedation. Use Caution/Monitor.Minor (1)ethanol, amitriptyline. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive impairment of motor skills.ethinylestradiolMinor (1)ethinylestradiol, amitriptyline. Mechanism: