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Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iopamidol. Your family or other caregivers should also be alert to changes in your mood or symptoms.This medicine can harm an unborn baby or cause birth defects. Monitor patient closely for evidence of CNS depression.Methylene Blue: Tricyclic Antidepressants may enhance the serotonergic effect of Methylene Blue. Take your next dose at the regular time. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) and increased cardiovascular effects when these agents are combined.Anticholinergic Agents: May enhance the adverse/toxic effect of other Anticholinergic Agents.Antiemetics (5HT3 Antagonists): May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Amitriptyline and chlordiazepoxide may also be used for purposes not listed in this medication guide. Management: Avoid concomitant use of anticholinergic agents and secretin. No such dose change is recommended for women. The degree of sedation is very high relative to other antidepressants.• Fractures: Bone fractures have been associated with antidepressant treatment. CYP2D6 Inhibitors (Strong) may increase the serum concentration of Amitriptyline.CYP3A4 Inducers (Moderate): May decrease the serum concentration of CYP3A4 Substrates (High risk with Inducers).CYP3A4 Inducers (Strong): May increase the metabolism of CYP3A4 Substrates (High risk with Inducers). Management: The manufacturer of Diclegis (doxylamine/pyridoxine), intended for use in pregnancy, specifically states that use with other CNS depressants is not recommended.Dronabinol: May enhance the CNS depressant effect of CNS Depressants.Dronedarone: Tricyclic Antidepressants may enhance the arrhythmogenic effect of Dronedarone. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.Dextromethorphan: May enhance the serotonergic effect of Serotonergic Agents (High Risk). PARoxetine: May enhance the serotonergic effect of Tricyclic Antidepressants. Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents.Oxitriptan: Serotonergic Agents (High Risk) may enhance the serotonergic effect of Oxitriptan. Management: Minimize doses of CYP3A4 substrates, and monitor for increased concentrations/toxicity, during and 2 weeks following treatment with mifepristone. Chlordiazepoxide and amitriptyline combination is used to treat mental depression that occurs with anxiety or nervous tension. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) and increased TCA concentrations/effects if these agents are combined.Esketamine: May enhance the CNS depressant effect of CNS Depressants.Fenfluramine: May enhance the serotonergic effect of Serotonergic Agents (High Risk). This medicine is available only with your doctor's prescription. These effects are specific to the GI tract.Procarbazine: May enhance the adverse/toxic effect of Tricyclic Antidepressants. Amitriptyline is a tricyclic antidepressant.
Azelastine (Nasal): CNS Depressants may enhance the CNS depressant effect of Azelastine (Nasal).
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