AdultPediatricGeriatricDepression Initiate at low dose (10 mg/day) and gradually titrate upward every 5-7 days 15-60 mg/day PO divided q6-8hr; not to exceed 60 mg/dayDosage Forms & Strengths tablet 5mg 10mg Depression <12 years: Safety and efficacy not established ≥12 years: 15-20 mg PO qDay See Black Box Warning5 mg PO q8hr initially; increase by 5-10 mg q3-7days PRN; cardiovascular adverse effects may increase if doses exceed 20 mg/dayInteraction CheckerEnter a drug name and protriptylineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (15)disopyramideprotriptyline and disopyramide both increase QTc interval. Contraindicated.ibutilideprotriptyline and ibutilide both increase QTc interval. Contraindicated.indapamideprotriptyline and indapamide both increase QTc interval. Contraindicated.iobenguane I 123protriptyline decreases effects of iobenguane I 123 by pharmacodynamic antagonism. Contraindicated. If clinically appropriate, discontinue drugs that decrease uptake of NE for at least 5 half-lives; may cause false-negative imaging results.isocarboxazidisocarboxazid and protriptyline both increase serotonin levels. Contraindicated.pentamidineprotriptyline and pentamidine both increase QTc interval. Contraindicated.phenelzinephenelzine and protriptyline both increase serotonin levels. Contraindicated.pimozideprotriptyline and pimozide both increase QTc interval. Contraindicated.procainamideprotriptyline and procainamide both increase QTc interval. Contraindicated.procarbazineprocarbazine and protriptyline both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.quinidinequinidine and protriptyline both increase QTc interval. Contraindicated.safinamideprotriptyline, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.selegilineselegiline and protriptyline both increase serotonin levels. Contraindicated. Concurrent use or use within 14 days of selegiline treatment is contraindicatedsotalolprotriptyline and sotalol both increase QTc interval. Contraindicated.tranylcyprominetranylcypromine and protriptyline both increase serotonin levels. Contraindicated.Serious - Use Alternative (141)adagrasibadagrasib, protriptyline. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.albuterolprotriptyline, albuterol. 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.amiodaroneprotriptyline and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.amitriptylineamitriptyline and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.amoxapineamoxapine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.amoxapine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.apomorphineapomorphine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.arformoterolprotriptyline, arformoterol. 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.arsenic trioxideprotriptyline and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.artemetherartemether and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineprotriptyline and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen and protriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebenzphetamineprotriptyline, benzphetamine. 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.buprenorphinebuprenorphine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalbuprenorphine buccal and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantbuprenorphine subdermal implant and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implant and protriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine transdermalbuprenorphine transdermal and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermal and protriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine, long-acting injectionbuprenorphine, long-acting injection and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injection and protriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuspironeprotriptyline and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.calcium/magnesium/potassium/sodium oxybatesprotriptyline, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.chlorpromazinechlorpromazine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.citalopramcitalopram and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Citalopram may increase TCA levels. Increased risk of serotonin syndrome or neuroleptic malignant syndrome. Potential risk for QT prolongation. ECG monitoring is recommended.citalopram and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.clarithromycinprotriptyline and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.clomipramineclomipramine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.clomipramine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.clonidineprotriptyline decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.cyclobenzaprineprotriptyline and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.dacomitinibdacomitinib will increase the level or effect of protriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. desipraminedesipramine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.desipramine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.desvenlafaxineprotriptyline and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.dexfenfluramineprotriptyline, 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.dexmethylphenidateprotriptyline, 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.dextroamphetamineprotriptyline, 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.dextromethorphanprotriptyline and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.diethylpropionprotriptyline, 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.dobutamineprotriptyline, 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.dofetilideprotriptyline and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.dolasetrondolasetron, protriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.dopamineprotriptyline, 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.dopexamineprotriptyline, 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.doxepindoxepin and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.doxepin and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.dronedaroneprotriptyline and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.droperidolprotriptyline and droperidol both increase QTc interval. Avoid or Use Alternate Drug.duloxetineduloxetine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.encorafenibencorafenib and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.ephedrineprotriptyline, 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.epinephrineepinephrine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.protriptyline, 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 racemicepinephrine racemic and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.protriptyline, 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.erythromycin baseprotriptyline and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.erythromycin ethylsuccinateprotriptyline and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin lactobionateprotriptyline and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin stearateprotriptyline and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.escitalopramescitalopram and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.fenfluramineprotriptyline, fenfluramine. 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.fexinidazolefexinidazole and protriptyline both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.fluconazoleprotriptyline and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.fluoxetinefluoxetine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.fluphenazinefluphenazine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.fluvoxaminefluvoxamine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.formoterolprotriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.protriptyline, formoterol. 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.fosamprenavirfosamprenavir increases levels of protriptyline by decreasing metabolism. Avoid or Use Alternate Drug.givosirangivosiran will increase the level or effect of protriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.granisetrongranisetron, protriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.guanfacineprotriptyline decreases effects of guanfacine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.haloperidolprotriptyline and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.hydroxychloroquine sulfatehydroxychloroquine sulfate and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.imipramineimipramine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.imipramine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.iobenguane I 131protriptyline will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.isoproterenolprotriptyline, isoproterenol. 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.itraconazoleprotriptyline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.ivosidenibivosidenib and protriptyline both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of 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.ketoconazoleprotriptyline and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.levalbuterolprotriptyline, 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.levoketoconazoleprotriptyline and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.levomilnacipranlevomilnacipran and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.linezolidlinezolid and protriptyline 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.lisdexamfetamineprotriptyline, 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