What happens when Protriptyline is used with some other drugs?

When Protriptyline is used with some other drugs, it can lead to adverse symptoms that need immediate medical attention. This article will mention some drugs that interact with Protriptyline and their effects, though the list is endless.

When Protriptyline is used with sympatho-mimetic drugs and anticholinergic agents including combined local anaesthetics with epinephrine, careful dosage adjustment and careful supervision is necessary. Using Protriptyline with neuroleptic drugs or anticholinergic agents lead to Hyperpyrexia, especially when used during hot weather.

Protriptyline and Cimetidine

Cimetidine when taken in combination with Protriptyline can reduce the hepatic metabolism of Protriptyline thereby delaying removal and increasing constant concentration of antidepressants. It has been reported that using cimetidine simultaneously with Protriptyline can increase the plasma levels of Protriptyline and can also increases the severity and frequency of possible side effects, especially anticholinergic.

Protriptyline and modafinil

Before starting with Protriptyline, let your doctor know that you are using modafinil. The combination of these two medications can cause

  • dry mouth
  • sedation
  • constipation
  • blurred vision
  • urinary retention

If you are using these two medications together and notice any of the symptoms above, seek medical help immediately. You doctor might suggest a dose adjustment if you are using the two medications together. It is very important to inform your doctor about other medicines that you are using like herbs, vitamins etc., do not stop taking any of the medications without your doctor’s advice.

Protriptyline and Butalbital

Taking Protriptyline with butalbital can affect the efficacy of one of the medications. This can be more dangerous if you are taking butalbital to control seizures. Speak to your doctor if you are using these medications together. Your doctor might suggest you a dose adjustment or some special tests so that you can use the medications safely. . It is very important to inform your doctor about other medicines that you are using like herbs, or vitamins. Do not stop taking any of the medications without your doctor’s advice.

Protriptyline and Pregabalin

Taking Protriptyline and Pregabalin together can increase some side effects like

  • drowsiness
  • difficulty in concentrating
  • dizziness
  • confusion

Elderly people often experience impairment in judgement, thinking and motor coordination. Do not consume alcohol or get involved in activities that need you to be extra alert or operating heavy machinery till the time you are not sure how your body responds to the medication. You can discuss with your doctor if you have any doubts or concerns. Also discuss with your doctor if you are using any other medications like herbs or vitamins. Avoid halting the use of any medications without your doctor’s consent.

Taking Protriptyline with some drugs can slow your breathing or make you feel sleepy. Also check with your doctor if you are using Protriptyline with a narcotic pain medicine, sleeping pill, and muscle relaxer, medicine for seizures, depression or anxiety.

If you are using Protriptyline and taken an SSRI in last 5 weeks let your doctor know about it. The SSRIs can be sertraine, fluoxetine, fluvoxamine etc.

Some important and safety information about Protriptyline

Protriptyline is basically used to treat depression. It can also be used to treat other health ailments as recommended by the doctor. It is a tricyclic antidepressant which works by enhancing the action of certain chemicals present in the brain that helps boost your mood.

Avoid using Protriptyline if

  1. you are allergic to any of the ingredients present in Protriptyline or to similar drugs
  2. you have used linezolid, furazolidone or MAO in last 14 days
  3. you are regaining health after a recent heart attack
  4. you are using cisapride

Speak to your doctor if the above mentioned things are applicable to you.

Remember the following points before you use Protriptyline

Some medicals conditions can interact with Protriptyline. Inform your doctor if you are suffering from any medical conditions especially

  • if you are planning to conceive or you are pregnant and also if you are a nursing mother
  • If you are allergic to certain substances, food or medicines.
  • if you are using any prescription/non prescription, dietary supplement or herbal preparation
  • if you consume beverages containing alcohol or have a history of alcohol addiction
  • if you use thyroid medicine or had a overactive thyroid in the past, heart problems, liver or kidney problems, glaucoma, seizures, porphyria, diabetes, , difficulty in urinating or enlarged prostate.
  • If you are using a medicine that comprises of methylene blue.
  • If you have bipolar disorder, suicidal behaviour or thoughts or any other mood or mental disorder.
  • If any surgery is scheduled or you had undergone electroshock therapy.

Safety Information

  • Diabetic patients should be extra careful while using Protriptyline as it can influence their blood sugar levels.  Monitor your blood sugar level regularly. Check with your doctor before changing the dose of your diabetic medication.
  • Protriptyline can also increase the skin sensitivity to the sun. Avoid exposure to sunlamps, sunlight, tanning booths till the time you know how your body responds to Protriptyline. If you need to go outside for a long duration, use protective clothing or sunscreen.
  • Protriptyline should be used very carefully in elderly patients as they are quite sensitive to Protriptyline effects like irregular heartbeat, confusion and fluctuations in blood pressure.
  • In case of children the medicine should be used with extra caution as its efficacy in children is not confirmed yet.
  • While using Protriptyline, certain lab test can be carried out like blood cell counts. These tests can be used to check for any side effects that might occur and also to monitor your medical condition.
  • Some people also tend to develop eye problems while using Protriptyline. Your doctor will examine your eye to check for any possible risks. Contact your doctor in case you experience vision changes, eye pain, redness or swelling around your eyes.

Is Protriptyline addictive?

No. It is not addictive, but possible withdrawal symptoms can be seen if Protriptyline is stopped suddenly after a long term treatment like headache, malaise and nausea.

Protriptyline dosage adjustments for maximum benefits

Protriptyline should be started with a low dosage and increased slowly considering the indication of intolerance and clinical response.

Normal Adult Dosage

15-40mg/day in split of 3-4 doses and if required dosage can be increased to 60mg/day

Dosage exceeding the above limit is strictly not recommended. Dose increment should be done in morning dose.

Elderly patients and Adolescents

Generally low doses are prescribed for this section.

Initial dose

5mg – 3 times/day and can be increased slowly if required. In case of elderly patients cardiovascular system should be monitored regularly if the dose exceeds 25mg

When satisfactory results are achieved, the dosage can be reduced to low dosages that can manage relief of symptoms.

Adverse conditions that are quite minor need dosage reduction. Adverse conditions that are quite major or indicate hypersensitivity require immediate halt of the drug.

While using Protriptyline you should read the label carefully to follow the instructions. Take Protriptyline orally with/without food. If you tend to miss a dose of Protriptyline, take it as soon as you recollect. If it is nearly the time for the next dose then skip the dose you have missed and get back to normal dosing schedule. Avoid taking 2 doses at a time. Do not take extra doses to make up for the missed doses.

Your doctor can change the dose to ensure best results. Use the medicines as prescribed by your doctor. If you are undergoing a surgery, inform your surgeon in advance that you are using Protriptyline. The surgeon might ask you to stop taking medicine for a few days.

Do not halt the use of Protriptyline suddenly or you can experience unexpected withdrawal symptoms. Check with your doctor to know how to use Protriptyline safely. To see the desired results it can take a couple of weeks so keep taking the medicine and let the doctor know if you think your symptoms are not improving.

Store the medicine away from heat and moisture in a room temperature. In case of overdose call poison control centre or medical help immediately.

Protriptyline over dosage and treatment

Protriptyline over dosage can even lead to death. Multiple drug consumptions are quite common in overdose of antidepressants. The management of overdose is quite challenging and with constant changes taking place in methods used to treat overdose, it is better to seek emergency medical help or call poison control centre to know about the current treatment method. Symptoms and sign of toxicity build faster after the overdose and therefore immediate hospitalization is a must.


Critical indications of Protriptyline over dosage include

  1. hypotension
  2. convulsions
  3. coma (CNS depression)
  4. cardiac dysrhythimias


Immediate ECG is obtained followed by cardiac monitoring. Patient’s airway is secured, establishment of intravenous line and initiating gastric decontamination is conducted. The patient is observed for at least 6 hours with cardiac monitoring to observe the signs of hypotension, cardiac dysrhythimias, seizures etc., and extended monitoring becomes necessary if the signs of toxicity appear at any time during the period of medical supervision.

Finding out whether Protriptyline is safe during breastfeeding and pregnancy

Well, there are always discussion going on whether using any antidepressant is safe during breastfeeding and pregnancy or not. Since there is lack of evidence available for so many antidepressants that support the use of medication during breastfeeding or pregnancy, most women find it difficult to know about the real facts. It is better to consult your doctor before you use any antidepressant or if you get pregnant while using antidepressants.

Protriptyline and Pregnancy

Whether the use of Protriptyline during pregnancy is safe or not, is still not known. FDA categorizes the medications as A, B, C, and D and X – to classify the related risks to unborn baby when the medicine is used during pregnancy.

Protriptyline is not yet classified in these categories as there are no evidences available that supports the use of Protriptyline in pregnancy. So it is said that a doctor can determine the benefits and risks linked to use of Protriptyline during pregnancy looking at the current medical condition of a pregnant woman and whether Protriptyline can cause harm to unborn baby.

Protriptyline and breastfeeding

When a woman has to breastfed her baby while taking Protriptyline, she can speak to her doctor if the medication is safe for her baby. Since there are no updated records available for use of Protriptyline during breastfeeding is safe or not, mothers can speak to their doctor to ensure child’s better health.

In case Protriptyline is required by breastfeeding mother, there is actually no reason to discontinue breastfeeding. However, no published data is available to justify the Protriptyline use during breastfeeding. There are no evidences available that help us know if the medication is secreted in breast milk. So consult your doctor for timely guidance.

Women often face depression, sleeping disorders etc., post child’s birth and it becomes necessary for them to take antidepressant to manage depression. Mothers know that while nursing their babies they have to be alert and to fight depression they need something effective. On other hand, some mothers also think about the possible risks of the medications especially when they have to take it for a long term.

Woman who is breastfeeding can also talk to their doctor to help them know about other alternative medications that can fight depression without causing harm to their baby. This will help them breastfed their babies without any hassles. Narcotic medications can always cause some harm to the baby, when used in a long run as the medication passes through breast milk to their body and accumulation of drugs for a long term can affect their health.

If you are using Protriptyline with your doctor’s consent, do not forget to monitor your baby’s health regularly. In case you notice any unusual symptoms, speak to your doctor immediately. Do not ignore the symptoms that are not usual, they might need immediate medical help. You should use medications under proper guidance of your doctor and visit your doctor regularly in case of any doubts or concerns.

All you need to know about Protriptyline

Protriptyline is antidepressants and preferred to treat issues related to depression and mood. In few cases it is also used to treat eating disorder like bulimia nervosa and treat obsessive, panic compulsion, enuresis and ADHD. It regulates the impulse transmission of nerve by maintaining the chemical balance in your brain.

You can see the effect of Protriptyline after one to two weeks of given therapy. It also helps decrease pain, especially neuralgic pain or neuropathic pain, by obstructing sodium channels.

This medication is basically used in treating depression and also treats the combined symptoms of depression and anxiety. The medication is absorbed easily in your gastrointestinal tract and gets metabolized in your liver with the help of hepatic enzymes.

If you are suffering from anxiety or depression, you should consult a counselor or therapist in order to get the right dose of this drug. A therapist helps you work out a solution that lasts long for mental health which is not achieved through medication alone. A therapist also helps you know your feelings and helps you convert your negative thoughts into positive ones. They can also help you incorporate a routine of self care that suits your daily life.

Side effects- Protriptyline

Like any other antidepressant, this medication too come with different side effects and make sure your doctor or pharmacist lets you know about the related side effects.

Effects related to Central Nervous system

  • Tremors
  • Poor coordination
  • Seizures
  • Headache
  • Changes in patterns of brain waves
  • Weakness, fatigue, drowsiness, dizziness

Effects- Cardiovascular

  • Heart block
  • Stroke
  • Orthostatic hypotension
  • Arrhythmias
  • Palpitation and reflex tachycardia

Effects – Gastrointestinal

  • Anorexia
  • Black tongue
  • Vomiting and nausea
  • Epigastric distress
  • Abdominal cramps

Hypersensitive reactions

Skin rash



Drug fever

Itching, skin rash or hives

Psychiatric effects

Increased agitation



Sleeping problems like insomnia, nightmares or restlessness


Some other adverse effects are suppression of bone marrow and obstructive jaundice. If someone is taking this medication then he/she might see changes in tests done for checking liver function. This drug can also cause alopecia, change in weight, swelling in parotid glands, and change in frequency of urination.


The use of this medication in children should be restricted as it can hinder their social behavior, cause severe change in their mood, increase suicidal thoughts. In elderly people it can lead to excessive sedation.

Those who suffer with the following conditions should speak to their doctor before starting with this medication




Heart diseases


Blood abnormalities or anemia


Also don’t stop using the medication without consulting your doctor even if you feel better or feel like the medication isn’t working for you. As there are withdrawal symptoms that can be severe as well, so let the doctor reduce your dose slowly to lessen the withdrawal symptoms. Stopping the use of medication suddenly can cause fatigue, nausea or the symptoms of depression can come back.