QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.ketamineMonitor Closely (1)ketamine and amitriptyline both increase sedation. Use Caution/Monitor.Minor (1)ketamine, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.ketoconazoleMonitor Closely (2)ketoconazole will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ketoconazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.ketotifen, ophthalmicMonitor Closely (1)amitriptyline and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.L-tryptophanMonitor Closely (1)amitriptyline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.lapatinibMonitor Closely (1)amitriptyline and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.Minor (1)lapatinib will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.lasmiditanMonitor Closely (2)lasmiditan, amitriptyline. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions. amitriptyline increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome.Serious - Use Alternative (1)lasmiditan increases effects of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.lefamulinSerious - Use Alternative (1)lefamulin and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.lemborexantMonitor Closely (1)lemborexant, amitriptyline. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.letermovirMonitor Closely (1)letermovir increases levels of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.levalbuterolMonitor Closely (1)amitriptyline increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, levalbuterol. 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.levofloxacinMonitor Closely (1)amitriptyline and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.levoketoconazoleMonitor Closely (2)levoketoconazole will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. levoketoconazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.levomilnacipranSerious - Use Alternative (1)levomilnacipran and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.levorphanolMonitor Closely (1)levorphanol and amitriptyline both increase sedation. Use Caution/Monitor.levothyroxineMonitor Closely (1)levothyroxine increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.linezolidSerious - Use Alternative (1)linezolid and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.liothyronineMonitor Closely (1)liothyronine increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.liotrixMonitor Closely (1)liotrix increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.lisdexamfetamineMonitor Closely (2)amitriptyline, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s). amitriptyline increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, lisdexamfetamine. 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.lithiumMonitor Closely (2)lithium and amitriptyline both increase QTc interval. Use Caution/Monitor. amitriptyline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)lithium, amitriptyline. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.lofepramineMonitor Closely (2)amitriptyline and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor. amitriptyline and lofepramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)amitriptyline and lofepramine both increase QTc interval. Avoid or Use Alternate Drug. amitriptyline and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug.lofexidineMonitor Closely (2)amitriptyline decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor. amitriptyline and lofexidine both increase sedation. Use Caution/Monitor.loprazolamMonitor Closely (1)loprazolam and amitriptyline both increase sedation. Use Caution/Monitor.loratadineMonitor Closely (1)loratadine will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.lorazepamMonitor Closely (1)lorazepam and amitriptyline both increase sedation. Use Caution/Monitor.lorcaserinMonitor Closely (1)lorcaserin will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lormetazepamMonitor Closely (1)lormetazepam and amitriptyline both increase sedation. Use Caution/Monitor.loxapineMonitor Closely (1)loxapine and amitriptyline both increase sedation. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)loxapine inhaled and amitriptyline both increase sedation. Use Caution/Monitor.lsdMonitor Closely (1)amitriptyline and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.lumefantrineSerious - Use Alternative (1)amitriptyline and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)lumefantrine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.lurasidoneMonitor Closely (2)lurasidone, amitriptyline. Either increases toxicity of the other by sedation. Use Caution/Monitor. Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity. lurasidone increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.macimorelinSerious - Use Alternative (1)macimorelin and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.maprotilineMonitor Closely (2)amitriptyline and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor. amitriptyline and maprotiline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)amitriptyline and maprotiline both increase QTc interval. Avoid or Use Alternate Drug. amitriptyline and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.maravirocMonitor Closely (1)maraviroc, amitriptyline. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.marijuanaMonitor Closely (1)amitriptyline and marijuana both increase sedation. Use Caution/Monitor.Minor (1)marijuana will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.mavacamtenMonitor Closely (1)amitriptyline will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. meclizineMonitor Closely (1)meclizine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.mefloquineSerious - Use Alternative (1)mefloquine increases toxicity of amitriptyline by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.melatoninMonitor Closely (1)amitriptyline and melatonin both increase sedation. Use Caution/Monitor.meperidineMonitor Closely (1)meperidine and amitriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.meprobamateMonitor Closely (1)amitriptyline and meprobamate both increase sedation. Use Caution/Monitor.mestranolMinor (1)mestranol, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.metaproterenolMonitor Closely (1)amitriptyline increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, metaproterenol. 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.metaxaloneMonitor Closely (1)metaxalone and amitriptyline both increase sedation. Use Caution/Monitor.metforminMinor (1)amitriptyline increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.methadoneMonitor Closely (2)amitriptyline and methadone both increase QTc interval. Modify Therapy/Monitor Closely. methadone and amitriptyline both increase sedation. Use Caution/Monitor.methamphetamineMonitor Closely (1)amitriptyline increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, methamphetamine. 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.methocarbamolMonitor Closely (1)methocarbamol and amitriptyline both increase sedation. Use Caution/Monitor.methscopolamineMonitor Closely (1)methscopolamine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.methylene blueSerious - Use Alternative (1)methylene blue and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.methylenedioxymethamphetamineMonitor Closely (1)amitriptyline increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, methylenedioxymethamphetamine. 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.methylphenidateMonitor Closely (1)amitriptyline, methylphenidate. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.methylphenidate transdermalMonitor Closely (1)methylphenidate transdermal will increase the level or effect of amitriptyline by decreasing elimination. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. methylprednisoloneMinor (1)methylprednisolone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.metoclopramide intranasalSerious - Use Alternative (1)amitriptyline, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.metronidazoleMinor (1)metronidazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.metyraponeMinor (1)amitriptyline decreases effects of metyrapone by unspecified interaction mechanism. Minor/Significance Unknown.miconazole vaginalMinor (1)miconazole vaginal will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.midazolamMonitor Closely (1)midazolam and amitriptyline both increase sedation. Use Caution/Monitor.midazolam intranasalMonitor Closely (1)midazolam intranasal, amitriptyline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.midodrineMonitor Closely (1)amitriptyline increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, midodrine. 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.mifepristoneMonitor Closely (1)mifepristone, amitriptyline. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.miglitolMinor (1)amitriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.milnacipranSerious - Use Alternative (1)milnacipran and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.mipomersenMonitor Closely (1)mipomersen, amitriptyline. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.mirabegronMonitor Closely (1)mirabegron will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirtazapineMonitor Closely (2)amitriptyline and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. amitriptyline and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.mobocertinibSerious - Use Alternative (1)mobocertinib will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequentlymodafinilMonitor Closely (2)modafinil will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. amitriptyline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.morphineMonitor Closely (2)amitriptyline and morphine both increase serotonin levels. Modify Therapy/Monitor Closely. morphine and amitriptyline both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)amitriptyline and motherwort both increase sedation. Use Caution/Monitor.moxifloxacinSerious - Use Alternative (1)amitriptyline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.moxonidineMonitor Closely (1)amitriptyline and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor