adrenergic neuron.lofepraminelofepramine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.lofepramine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.lorcaserinprotriptyline and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lumefantrineprotriptyline and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.macimorelinmacimorelin and protriptyline 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.maprotilinemaprotiline and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.maprotiline and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.mefloquinemefloquine increases toxicity of protriptyline by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.meperidineprotriptyline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.metaproterenolprotriptyline, 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.methamphetamineprotriptyline, 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.methylene bluemethylene blue and protriptyline 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.methylenedioxymethamphetamineprotriptyline, 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.metoclopramide intranasalprotriptyline, 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.midodrineprotriptyline, 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.milnacipranmilnacipran and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.mirtazapinemirtazapine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.mobocertinibmobocertinib and protriptyline both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.moxifloxacinprotriptyline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.nefazodonenefazodone and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.netupitant/palonosetronnetupitant/palonosetron, protriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.nilotinibprotriptyline and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.norepinephrineprotriptyline, norepinephrine. 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.nortriptylinenortriptyline and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.nortriptyline and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.octreotideprotriptyline and octreotide both increase QTc interval. Avoid or Use Alternate Drug.octreotide (Antidote)protriptyline and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.olopatadine intranasalprotriptyline and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. ondansetronprotriptyline and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.ondansetron, protriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.ozanimodozanimod increases toxicity of protriptyline by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.palonosetronpalonosetron, protriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.paroxetineparoxetine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.perphenazineperphenazine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.phendimetrazineprotriptyline, phendimetrazine. 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.phentermineprotriptyline, phentermine. 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.phenylephrineprotriptyline, phenylephrine. 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.phenylephrine POprotriptyline, phenylephrine PO. 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.pirbuterolprotriptyline, pirbuterol. 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.pitolisantprotriptyline decreases effects of pitolisant by Other (see comment). Avoid or Use Alternate Drug. Comment: Pitolisant increases histamine levels in the brain; therefore, H1 receptor antagonists that cross the blood-brain barrier may reduce the efficacy of pitolisant.promazinepromazine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.propylhexedrineprotriptyline, propylhexedrine. 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.pseudoephedrineprotriptyline 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.rasagilinerasagiline and protriptyline 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 protriptyline by QTc interval. Avoid or Use Alternate Drug.salmeterolprotriptyline, 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 protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.selinexorselinexor, protriptyline. 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/dexmethylphenidateprotriptyline, 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 protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.sertraline and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.sodium oxybateprotriptyline, 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 Wortprotriptyline and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.tacrolimustacrolimus and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.tedizolidtedizolid, protriptyline. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.terbutalineprotriptyline, 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 protriptyline both increase QTc interval. Avoid or Use Alternate Drug.trazodoneprotriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.trazodone and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.trifluoperazinetrifluoperazine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.trimipramineprotriptyline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.protriptyline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.umeclidinium bromide/vilanterol inhaledprotriptyline 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.protriptyline 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 potentiatedvandetanibprotriptyline, 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 protriptyline both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.venlafaxinevenlafaxine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.vilanterol/fluticasone furoate inhaledprotriptyline 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 potentiatedprotriptyline 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.vilazodoneprotriptyline, 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. .vortioxetineprotriptyline, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.xylometazolineprotriptyline, 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.yohimbeyohimbe, protriptyline. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.yohimbineprotriptyline, yohimbine. 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.ziprasidoneprotriptyline and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.Monitor Closely (347)5-HTPprotriptyline and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abirateroneabiraterone increases levels of protriptyline 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 protriptyline by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .aclidiniumaclidinium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.acrivastineacrivastine and protriptyline both increase sedation. Use Caution/Monitor.albuterolprotriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.albuterol and protriptyline both increase QTc interval. Use Caution/Monitor.alfentanilalfentanil and protriptyline both increase sedation. Use Caution/Monitor.alfuzosinprotriptyline and alfuzosin both increase QTc interval. Use Caution/Monitor.alfuzosin and protriptyline both increase QTc interval. Use Caution/Monitor.almotriptanalmotriptan and protriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.alprazolamalprazolam and protriptyline both increase sedation. Use Caution/Monitor.amifampridineprotriptyline 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.amisulprideprotriptyline and amisulpride both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.amitriptylineamitriptyline and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.amitriptyline and protriptyline both increase sedation. Use Caution/Monitor.amobarbitalamobarbital and protriptyline both increase sedation. Use Caution/Monitor.amoxapineamoxapine and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.amoxapine and protriptyline both increase sedation. Use Caution/Monitor.anagrelideanagrelide and protriptyline both increase QTc interval. Use