increase serotonin levels. Avoid or Use Alternate Drug.pseudoephedrineamitriptyline increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.quinidinequinidine will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.ranolazineranolazine will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.rasagilinerasagiline and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia has been reported with the combined treatment of an antidepressant and rasagiline. Avoid combination within 14 days of MAOI use.ribociclibribociclib increases toxicity of amitriptyline by QTc interval. Avoid or Use Alternate Drug.salmeterolamitriptyline, salmeterol. 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.selegiline transdermalselegiline transdermal and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.selinexorselinexor, amitriptyline. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.serdexmethylphenidate/dexmethylphenidateamitriptyline, serdexmethylphenidate/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.sertralinesertraline and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.sodium oxybatechlordiazepoxide, sodium oxybate. 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.amitriptyline, sodium oxybate. 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.St John's Wortamitriptyline and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.sufentanil SLsufentanil SL, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. 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.tedizolidtedizolid, amitriptyline. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.terbutalineamitriptyline, terbutaline. 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.thioridazinethioridazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.toremifeneamitriptyline and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.trazodoneamitriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.trazodone and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.trifluoperazinetrifluoperazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.trimipramineamitriptyline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.tucatinibtucatinib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.umeclidinium bromide/vilanterol inhaledamitriptyline increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.amitriptyline and umeclidinium bromide/vilanterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiatedvalerianvalerian and chlordiazepoxide both increase sedation. Avoid or Use Alternate Drug.vandetanibamitriptyline, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.vemurafenibvemurafenib and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.venlafaxinevenlafaxine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.vilanterol/fluticasone furoate inhaledamitriptyline and vilanterol/fluticasone furoate inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiatedamitriptyline increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.vilazodoneamitriptyline, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .vortioxetineamitriptyline, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.voxelotorvoxelotor will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.xylometazolineamitriptyline, xylometazoline. 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.Monitor Closely (491)5-HTPamitriptyline and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abirateroneabiraterone increases levels of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.abiraterone increases levels of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.abobotulinumtoxinAabobotulinumtoxinA increases effects of amitriptyline by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .acrivastineacrivastine and chlordiazepoxide both increase sedation. Use Caution/Monitor.aclidiniumaclidinium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.acrivastineacrivastine and amitriptyline both increase sedation. Use Caution/Monitor.albuterolalbuterol and amitriptyline both increase QTc interval. Use Caution/Monitor.chlordiazepoxide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.alfentanilalfentanil and amitriptyline both increase sedation. Use Caution/Monitor.chlordiazepoxide and alfentanil both increase sedation. Use Caution/Monitor.alfuzosinamitriptyline and alfuzosin both increase QTc interval. Use Caution/Monitor.alfuzosin and amitriptyline both increase QTc interval. Use Caution/Monitor.alprazolamalprazolam and chlordiazepoxide both increase sedation. Use Caution/Monitor.almotriptanalmotriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.alprazolamalprazolam and amitriptyline both increase sedation. Use Caution/Monitor.amifampridineamitriptyline increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.amiodaroneamiodarone will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.amisulprideamitriptyline and amisulpride both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.amisulpride and amitriptyline both increase sedation. Use Caution/Monitor.amisulpride and amitriptyline both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.amisulpride and chlordiazepoxide both increase sedation. Use Caution/Monitor.amitriptylinechlordiazepoxide and amitriptyline both increase sedation. Use Caution/Monitor.amobarbitalamobarbital will decrease the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.amobarbital will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.amobarbital and amitriptyline both increase sedation. Use Caution/Monitor.amobarbital, amitriptyline. Other (see comment). Use Caution/Monitor. 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.amobarbitalamobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.amobarbital will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.amoxapineamitriptyline and amoxapine both increase sedation. Use Caution/Monitor.chlordiazepoxide and amoxapine both increase sedation. Use Caution/Monitor.amitriptyline and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.anticholinergic/sedative combosanticholinergic/sedative combos and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.apomorphinechlordiazepoxide and apomorphine both increase sedation. Use Caution/Monitor.apomorphineamitriptyline and apomorphine both increase sedation. Use Caution/Monitor.apomorphine and amitriptyline both increase QTc interval. Use Caution/Monitor.aprepitantaprepitant will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.arformoterolarformoterol and amitriptyline both increase QTc interval. Use Caution/Monitor.chlordiazepoxide increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.aripiprazolearipiprazole and amitriptyline both increase sedation. Use Caution/Monitor.chlordiazepoxide and aripiprazole both increase sedation. Use Caution/Monitor.aripiprazole and amitriptyline both increase QTc interval. Use Caution/Monitor.armodafinilchlordiazepoxide increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.armodafinil will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.amitriptyline increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.asenapineasenapine and amitriptyline both increase sedation. Use Caution/Monitor.asenapine and amitriptyline both increase QTc interval. Use Caution/Monitor.asenapine and chlordiazepoxide both increase sedation. Use Caution/Monitor.asenapine transdermalasenapine transdermal and amitriptyline both increase QTc interval. Use Caution/Monitor.asenapine transdermal and amitriptyline both increase sedation. Use Caution/Monitor.asenapine transdermal and chlordiazepoxide both increase sedation. Use Caution/Monitor.atazanaviratazanavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.atazanavir will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atazanavir increases levels of amitriptyline by unspecified interaction mechanism. Use Caution/Monitor.atomoxetineatomoxetine and amitriptyline both increase QTc interval. Use Caution/Monitor.avapritinibavapritinib and chlordiazepoxide both increase sedation. Use Caution/Monitor.atorvastatinatorvastatin will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.atracuriumatracurium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.atropineatropine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.atropine IV/IMatropine IV/IM and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.avapritinibavapritinib and amitriptyline both increase sedation. Use Caution/Monitor.azelastineazelastine and amitriptyline both increase sedation. Use Caution/Monitor.azelastine and chlordiazepoxide both increase sedation. Use Caution/Monitor.azithromycinamitriptyline and azithromycin both increase QTc interval. Use Caution/Monitor.baclofenchlordiazepoxide and baclofen both increase sedation. Use Caution/Monitor.baclofenbaclofen and amitriptyline both increase sedation. Use Caution/Monitor.bedaquilineamitriptyline and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsbelladonna alkaloids and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.belladonna and opiumchlordiazepoxide and belladonna and opium both increase sedation. Use Caution/Monitor.belladonna and opium and amitriptyline both increase sedation. Use Caution/Monitor.belladonna and opium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.belzutifanbelzutifan will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. benperidolbenperidol and amitriptyline both increase sedation. Use Caution/Monitor.benperidolchlordiazepoxide and benperidol both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, 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.benzphetaminechlordiazepoxide increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benztropinebenztropine and