amoxapine (Rx)

Brand and Other Names:Asendin
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 25mg
  • 50mg
  • 100mg
  • 150mg

Depression

Initiate at low dose (25 mg q8-12hr) and gradually titrate upward every 5-7 days up to 200-300 mg PO qHS

If dose exceeds 300 mg/day, administer in divided doses q12hr

Outpatient: Not to exceed 400 mg/day

Inpatient: May require higher doses, up to 600 mg/day divided q12hr

Not recommended

Use caution; avoid use

Depression

Initiate at low dose (25 mg q8-12hr) and gradually titrate upward every 5-7 days up to 200-300 mg PO qHS

If dose exceeds 300 mg/day, administer in divided doses q12hr

Outpatient: Not to exceed 400 mg/day

Inpatient: May require higher doses, up to 600 mg/day divided q12hr

Next:

Interactions

Interaction Checker

and amoxapine

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      Serious - Use Alternative

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            Contraindicated (17)

            • disopyramide

              amoxapine and disopyramide both increase QTc interval. Contraindicated.

            • ibutilide

              amoxapine and ibutilide both increase QTc interval. Contraindicated.

            • indapamide

              amoxapine and indapamide both increase QTc interval. Contraindicated.

            • iobenguane I 123

              amoxapine 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.

            • isocarboxazid

              isocarboxazid and amoxapine both increase serotonin levels. Contraindicated.

            • linezolid

              linezolid and amoxapine both increase serotonin levels. Contraindicated.

            • pentamidine

              amoxapine and pentamidine both increase QTc interval. Contraindicated.

            • phenelzine

              phenelzine and amoxapine both increase serotonin levels. Contraindicated.

            • pimozide

              amoxapine and pimozide both increase QTc interval. Contraindicated.

            • procainamide

              amoxapine and procainamide both increase QTc interval. Contraindicated.

            • procarbazine

              procarbazine and amoxapine both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.

            • quinidine

              quinidine and amoxapine both increase QTc interval. Contraindicated.

            • safinamide

              amoxapine, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.

            • selegiline

              selegiline and amoxapine both increase serotonin levels. Contraindicated. Concurrent use or use within 14 days of selegiline treatment is contraindicated

            • sotalol

              amoxapine and sotalol both increase QTc interval. Contraindicated.

            • tranylcypromine

              tranylcypromine and amoxapine both increase serotonin levels. Contraindicated.

            • ziprasidone

              ziprasidone and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Contraindicated.

            Serious - Use Alternative (122)

            • albuterol

              amoxapine, 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.

            • amiodarone

              amoxapine and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.

            • amitriptyline

              amitriptyline and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

              amitriptyline and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • arformoterol

              amoxapine, 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 trioxide

              amoxapine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.

            • artemether

              artemether and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

            • artemether/lumefantrine

              amoxapine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • benzphetamine

              amoxapine, 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.

            • buspirone

              amoxapine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.

            • calcium/magnesium/potassium/sodium oxybates

              amoxapine, 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.

            • chlorpromazine

              chlorpromazine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

            • citalopram

              citalopram and amoxapine 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.

            • clarithromycin

              amoxapine and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.

            • clomipramine

              amoxapine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • clonidine

              amoxapine decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.

            • cyclobenzaprine

              amoxapine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.

            • dacomitinib

              dacomitinib will increase the level or effect of amoxapine 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.

            • desipramine

              amoxapine and desipramine both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • desvenlafaxine

              amoxapine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

            • dexfenfluramine

              amoxapine, 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.

            • dexmethylphenidate

              amoxapine, 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.

            • dextroamphetamine

              amoxapine, 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.

            • dextromethorphan

              amoxapine and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.

            • diethylpropion

              amoxapine, 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.

            • dobutamine

              amoxapine, 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.

            • dofetilide

              amoxapine and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.

            • dolasetron

              dolasetron, amoxapine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • dopamine

              amoxapine, 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.

            • dopexamine

              amoxapine, 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.

            • dosulepin

              amoxapine and dosulepin both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.

            • doxepin

              amoxapine and doxepin both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.

            • dronedarone

              amoxapine and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.

            • droperidol

              amoxapine and droperidol both increase QTc interval. Avoid or Use Alternate Drug.

            • duloxetine

              duloxetine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • ephedrine

              amoxapine, 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.

            • epinephrine

              epinephrine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine, 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 racemic

              epinephrine racemic and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine, 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 base

              amoxapine and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin ethylsuccinate

              amoxapine and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin lactobionate

              amoxapine and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin stearate

              amoxapine and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.

            • escitalopram

              escitalopram and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • fenfluramine

              amoxapine, 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.

            • fexinidazole

              fexinidazole and amoxapine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.

            • fluconazole

              amoxapine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • fluoxetine

              fluoxetine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • fluphenazine

              fluphenazine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

            • fluvoxamine

              fluvoxamine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • formoterol

              amoxapine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine, 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.

            • fosamprenavir

              fosamprenavir increases levels of amoxapine by decreasing metabolism. Avoid or Use Alternate Drug.

            • givosiran

              givosiran will increase the level or effect of amoxapine 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.

            • granisetron

              granisetron, amoxapine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • guanfacine

              amoxapine decreases effects of guanfacine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.

            • haloperidol

              amoxapine and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.

            • hydroxychloroquine sulfate

              hydroxychloroquine sulfate and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

            • imipramine

              amoxapine and imipramine both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • iobenguane I 131

              amoxapine 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.

            • isoproterenol

              amoxapine, 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.

            • ivosidenib

              ivosidenib and amoxapine 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.

            • ketoconazole

              amoxapine and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • levalbuterol

              amoxapine, 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.

            • levomilnacipran

              levomilnacipran and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • lisdexamfetamine

              amoxapine, 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 adrenergic neuron.

            • lofepramine

              amoxapine and lofepramine both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • lumefantrine

              amoxapine and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • macimorelin

              macimorelin and amoxapine 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.

            • maprotiline

              amoxapine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

            • mefloquine

              mefloquine increases toxicity of amoxapine by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.

            • meperidine

              amoxapine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.

            • metaproterenol

              amoxapine, 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.

            • methamphetamine

              amoxapine, 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 blue

              amoxapine and methylene blue 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.

            • methylenedioxymethamphetamine

              amoxapine, 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 intranasal

              amoxapine, 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.

            • midodrine

              amoxapine, 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.

            • milnacipran

              milnacipran and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • moxifloxacin

              amoxapine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • nefazodone

              nefazodone and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • netupitant/palonosetron

              netupitant/palonosetron, amoxapine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • nilotinib

              amoxapine and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

            • norepinephrine

              amoxapine, 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.

            • nortriptyline

              amoxapine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

            • octreotide

              amoxapine and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

            • octreotide (Antidote)

              amoxapine and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

            • ondansetron

              amoxapine 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, amoxapine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • ozanimod

              ozanimod increases toxicity of amoxapine 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.

            • palonosetron

              palonosetron, amoxapine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • paroxetine

              paroxetine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • perphenazine

              perphenazine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

            • phendimetrazine

              amoxapine, 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.

            • phentermine

              amoxapine, 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.

            • phenylephrine

              amoxapine, 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 PO

              amoxapine, 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.

            • pirbuterol

              amoxapine, 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.

            • pitolisant

              amoxapine 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.

            • promazine

              promazine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

            • propylhexedrine

              amoxapine, 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.

            • protriptyline

              amoxapine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

            • pseudoephedrine

              amoxapine 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.

            • rasagiline

              rasagiline and amoxapine 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.

            • salmeterol

              amoxapine, 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 transdermal

              selegiline transdermal and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • selinexor

              selinexor, amoxapine. 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.

            • sertraline

              sertraline and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • sodium oxybate

              amoxapine, 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 Wort

              amoxapine and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.

            • tedizolid

              tedizolid, amoxapine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.

            • terbutaline

              amoxapine, 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.

            • thioridazine

              thioridazine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

            • trazodone

              amoxapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

              trazodone and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • trifluoperazine

              trifluoperazine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

            • trimipramine

              amoxapine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.

              amoxapine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.

            • umeclidinium bromide/vilanterol inhaled

              amoxapine 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.

              amoxapine 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 potentiated

            • vandetanib

              amoxapine, 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.

            • vemurafenib

              vemurafenib and amoxapine both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.

            • venlafaxine

              venlafaxine and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

            • vilanterol/fluticasone furoate inhaled

              amoxapine 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 potentiated

              amoxapine 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.

            • vortioxetine

              amoxapine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.

            • xylometazoline

              amoxapine, 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.

            • yohimbe

              yohimbe, amoxapine. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.

            • yohimbine

              amoxapine, 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.

            • ziprasidone

              amoxapine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

            Monitor Closely (322)

            • 5-HTP

              amoxapine and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.

            • abiraterone

              abiraterone increases levels of amoxapine 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.

            • abobotulinumtoxinA

              abobotulinumtoxinA increases effects of amoxapine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .

            • aclidinium

              aclidinium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • albuterol

              amoxapine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • alfentanil

              alfentanil and amoxapine both increase sedation. Use Caution/Monitor.

            • almotriptan

              almotriptan and amoxapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • alprazolam

              alprazolam and amoxapine both increase sedation. Use Caution/Monitor.

            • amifampridine

              amoxapine 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.

            • amitriptyline

              amitriptyline and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amitriptyline and amoxapine both increase sedation. Use Caution/Monitor.

            • amobarbital

              amobarbital and amoxapine both increase sedation. Use Caution/Monitor.

            • anticholinergic/sedative combos

              anticholinergic/sedative combos and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • apomorphine

              amoxapine and apomorphine both increase sedation. Use Caution/Monitor.

            • arformoterol

              amoxapine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • aripiprazole

              aripiprazole and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              aripiprazole and amoxapine both increase sedation. Use Caution/Monitor.

              aripiprazole and amoxapine both increase QTc interval. Use Caution/Monitor.

            • armodafinil

              amoxapine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • atazanavir

              atazanavir increases levels of amoxapine by unspecified interaction mechanism. Use Caution/Monitor.

            • atracurium

              atracurium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • atropine

              atropine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • atropine IV/IM

              atropine IV/IM and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • azelastine

              azelastine and amoxapine both increase sedation. Use Caution/Monitor.

            • azithromycin

              amoxapine and azithromycin both increase QTc interval. Use Caution/Monitor.

            • baclofen

              baclofen and amoxapine both increase sedation. Use Caution/Monitor.

            • bedaquiline

              amoxapine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

            • belladonna alkaloids

              belladonna alkaloids and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • belladonna and opium

              belladonna and opium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              belladonna and opium and amoxapine both increase sedation. Use Caution/Monitor.

            • benperidol

              benperidol and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              benperidol and amoxapine both increase sedation. Use Caution/Monitor.

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen, amoxapine. 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.

            • benzphetamine

              amoxapine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • benztropine

              benztropine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

            • bethanechol

              bethanechol increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • brompheniramine

              brompheniramine and amoxapine both increase sedation. Use Caution/Monitor.

            • buprenorphine

              buprenorphine and amoxapine both increase sedation. Use Caution/Monitor.

            • buprenorphine buccal

              buprenorphine buccal and amoxapine both increase sedation. Use Caution/Monitor.

            • buprenorphine subdermal implant

              amoxapine, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • buprenorphine, long-acting injection

              amoxapine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • bupropion

              amoxapine increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.

              bupropion will increase the level or effect of amoxapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • butabarbital

              butabarbital and amoxapine both increase sedation. Use Caution/Monitor.

            • butalbital

              butalbital and amoxapine both increase sedation. Use Caution/Monitor.

            • butorphanol

              butorphanol and amoxapine both increase sedation. Use Caution/Monitor.

            • caffeine

              amoxapine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • carbachol

              carbachol increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • carbinoxamine

              carbinoxamine and amoxapine both increase sedation. Use Caution/Monitor.

            • carisoprodol

              carisoprodol and amoxapine both increase sedation. Use Caution/Monitor.

            • cenobamate

              cenobamate, amoxapine. Either increases effects of the other by sedation. Use Caution/Monitor.

            • cevimeline

              cevimeline increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chloral hydrate

              chloral hydrate and amoxapine both increase sedation. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide and amoxapine both increase sedation. Use Caution/Monitor.

            • chloroquine

              chloroquine increases toxicity of amoxapine by QTc interval. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine and amoxapine both increase sedation. Use Caution/Monitor.

            • chlorpromazine

              chlorpromazine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              chlorpromazine and amoxapine both increase sedation. Use Caution/Monitor.

            • chlorzoxazone

              chlorzoxazone and amoxapine both increase sedation. Use Caution/Monitor.

            • cinnarizine

              cinnarizine and amoxapine both increase sedation. Use Caution/Monitor.

            • cisatracurium

              cisatracurium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • clemastine

              clemastine and amoxapine both increase sedation. Use Caution/Monitor.

            • clobazam

              clobazam will increase the level or effect of amoxapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly.

              amoxapine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

            • clomipramine

              amoxapine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and clomipramine both increase sedation. Use Caution/Monitor.

            • clonazepam

              clonazepam and amoxapine both increase sedation. Use Caution/Monitor.

            • clorazepate

              clorazepate and amoxapine both increase sedation. Use Caution/Monitor.

            • clozapine

              clozapine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              clozapine and amoxapine both increase sedation. Use Caution/Monitor.

            • cobicistat

              cobicistat will increase the level or effect of amoxapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Carefully titrate antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitoring for antidepressant response

              cobicistat will increase the level or effect of amoxapine by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with TCAs and cobicistat.

            • cocaine

              amoxapine and cocaine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • codeine

              codeine and amoxapine both increase sedation. Use Caution/Monitor.

            • crizotinib

              crizotinib and amoxapine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

            • cyclizine

              cyclizine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              cyclizine and amoxapine both increase sedation. Use Caution/Monitor.

            • cyclobenzaprine

              cyclobenzaprine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              cyclobenzaprine and amoxapine both increase sedation. Use Caution/Monitor.

            • cyproheptadine

              cyproheptadine and amoxapine both increase sedation. Use Caution/Monitor.

            • dantrolene

              dantrolene and amoxapine both increase sedation. Use Caution/Monitor.

            • darifenacin

              darifenacin and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • dasatinib

              amoxapine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.

            • debrisoquine

              amoxapine decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.

            • desflurane

              desflurane and amoxapine both increase sedation. Use Caution/Monitor.

            • desipramine

              amoxapine and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and desipramine both increase sedation. Use Caution/Monitor.

            • deutetrabenazine

              amoxapine and deutetrabenazine both increase sedation. Use Caution/Monitor.

            • dexchlorpheniramine

              dexchlorpheniramine and amoxapine both increase sedation. Use Caution/Monitor.

            • dexfenfluramine

              amoxapine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amoxapine and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dexmedetomidine

              dexmedetomidine and amoxapine both increase sedation. Use Caution/Monitor.

            • dexmethylphenidate

              amoxapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextroamphetamine

              amoxapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amoxapine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              amoxapine increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • dextromoramide

              dextromoramide and amoxapine both increase sedation. Use Caution/Monitor.

            • diamorphine

              diamorphine and amoxapine both increase sedation. Use Caution/Monitor.

            • diazepam

              diazepam and amoxapine both increase sedation. Use Caution/Monitor.

            • diazepam intranasal

              diazepam intranasal, amoxapine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

            • dicyclomine

              dicyclomine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • diethylpropion

              amoxapine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • difenoxin hcl

              difenoxin hcl and amoxapine both increase sedation. Use Caution/Monitor.

            • dihydroergotamine

              amoxapine and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dihydroergotamine intranasal

              amoxapine and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dimenhydrinate

              dimenhydrinate and amoxapine both increase sedation. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              diphenhydramine and amoxapine both increase sedation. Use Caution/Monitor.

            • diphenoxylate hcl

              diphenoxylate hcl and amoxapine both increase sedation. Use Caution/Monitor.

            • dipipanone

              dipipanone and amoxapine both increase sedation. Use Caution/Monitor.

            • dobutamine

              amoxapine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dofetilide

              dofetilide increases toxicity of amoxapine by QTc interval. Use Caution/Monitor.

            • dolasetron

              amoxapine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.

            • donepezil

              donepezil increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopamine

              amoxapine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopexamine

              amoxapine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dosulepin

              amoxapine and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and dosulepin both increase sedation. Use Caution/Monitor.

            • doxepin

              amoxapine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and doxepin both increase sedation. Use Caution/Monitor.

            • doxylamine

              doxylamine and amoxapine both increase sedation. Use Caution/Monitor.

            • droperidol

              droperidol and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              droperidol and amoxapine both increase sedation. Use Caution/Monitor.

            • echothiophate iodide

              echothiophate iodide increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • eletriptan

              eletriptan and amoxapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • eliglustat

              eliglustat increases levels of amoxapine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.

            • elvitegravir/cobicistat/emtricitabine/tenofovir DF

              elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of amoxapine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

            • ephedrine

              amoxapine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amoxapine increases effects of ephedrine by unknown mechanism. Use Caution/Monitor.

            • epinephrine

              amoxapine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amoxapine increases effects of epinephrine by unknown mechanism. Use Caution/Monitor.

            • epinephrine inhaled

              amoxapine and epinephrine inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Tricyclic antidepressants may potentiate epinephrine effect on cardiovascular system.

            • epinephrine racemic

              amoxapine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amoxapine increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

            • ergotamine

              amoxapine and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • escitalopram

              escitalopram increases toxicity of amoxapine by QTc interval. Use Caution/Monitor.

            • esketamine intranasal

              esketamine intranasal, amoxapine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

            • estazolam

              estazolam and amoxapine both increase sedation. Use Caution/Monitor.

            • ethanol

              amoxapine and ethanol both increase sedation. Use Caution/Monitor.

            • etomidate

              etomidate and amoxapine both increase sedation. Use Caution/Monitor.

            • ezogabine

              ezogabine, amoxapine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

            • fedratinib

              fedratinib will increase the level or effect of amoxapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.

            • fenfluramine

              amoxapine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amoxapine and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.

              fenfluramine, amoxapine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.

            • fesoterodine

              fesoterodine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • flavoxate

              flavoxate and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • flecainide

              amoxapine and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.

            • fluoxetine

              amoxapine and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.

            • fluphenazine

              fluphenazine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              fluphenazine and amoxapine both increase sedation. Use Caution/Monitor.

            • flurazepam

              flurazepam and amoxapine both increase sedation. Use Caution/Monitor.

            • fluvoxamine

              fluvoxamine and amoxapine both increase QTc interval. Modify Therapy/Monitor Closely.

            • formoterol

              amoxapine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • foscarnet

              amoxapine and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.

            • frovatriptan

              frovatriptan and amoxapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • gabapentin

              gabapentin, amoxapine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • gabapentin enacarbil

              gabapentin enacarbil, amoxapine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • galantamine

              galantamine increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • glycopyrrolate

              glycopyrrolate and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine increases levels of glycopyrrolate by unknown mechanism. Use Caution/Monitor.

            • glycopyrrolate inhaled

              glycopyrrolate inhaled and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.

            • glycopyrronium tosylate topical

              glycopyrronium tosylate topical, amoxapine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

            • haloperidol

              haloperidol and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              haloperidol and amoxapine both increase sedation. Use Caution/Monitor.

            • henbane

              henbane and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • homatropine

              homatropine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • huperzine A

              huperzine A increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hydrocodone

              hydrocodone, amoxapine. 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.

            • hydromorphone

              hydromorphone and amoxapine both increase sedation. Use Caution/Monitor.

            • hydroxyzine

              hydroxyzine and amoxapine both increase sedation. Use Caution/Monitor.

            • hyoscyamine

              hyoscyamine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • hyoscyamine spray

              hyoscyamine spray and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • iloperidone

              iloperidone and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              amoxapine and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              iloperidone and amoxapine both increase sedation. Use Caution/Monitor.

            • imipramine

              amoxapine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and imipramine both increase sedation. Use Caution/Monitor.

            • indacaterol, inhaled

              indacaterol, inhaled, amoxapine. QTc interval. Use Caution/Monitor. Indacaterol should be administered with extreme caution to patients treated with TCAs. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

            • ioflupane I 123

              amoxapine decreases effects of ioflupane I 123 by receptor binding competition. Use Caution/Monitor. Drugs that bind to dopamine transporter receptor with high affinity may interfere with the image following ioflupane I123 administration.

            • ipratropium

              ipratropium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.

            • isoniazid

              amoxapine and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely.

            • isoproterenol

              amoxapine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ketamine

              ketamine and amoxapine both increase sedation. Use Caution/Monitor.

            • ketotifen, ophthalmic

              amoxapine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

            • L-tryptophan

              amoxapine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.

            • lapatinib

              amoxapine and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.

            • lasmiditan

              lasmiditan, amoxapine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

              amoxapine increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome.

            • lemborexant

              lemborexant, amoxapine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

            • levalbuterol

              amoxapine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • levofloxacin

              amoxapine and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • levorphanol

              levorphanol and amoxapine both increase sedation. Use Caution/Monitor.

            • lisdexamfetamine

              amoxapine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amoxapine, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

            • lithium

              amoxapine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.

            • lofepramine

              amoxapine and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and lofepramine both increase sedation. Use Caution/Monitor.

            • lofexidine

              amoxapine and lofexidine both increase sedation. Use Caution/Monitor.

              amoxapine decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor.

            • loprazolam

              loprazolam and amoxapine both increase sedation. Use Caution/Monitor.

            • lorazepam

              lorazepam and amoxapine both increase sedation. Use Caution/Monitor.

            • lorcaserin

              lorcaserin will increase the level or effect of amoxapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • lormetazepam

              lormetazepam and amoxapine both increase sedation. Use Caution/Monitor.

            • loxapine

              loxapine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              loxapine and amoxapine both increase sedation. Use Caution/Monitor.

            • loxapine inhaled

              loxapine inhaled and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              loxapine inhaled and amoxapine both increase sedation. Use Caution/Monitor.

            • lsd

              amoxapine and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.

            • lurasidone

              amoxapine, lurasidone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive CNS effects .

              lurasidone and amoxapine both increase pharmacodynamic synergism. Use Caution/Monitor. Potential for additive CNS effects

            • maprotiline

              amoxapine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and maprotiline both increase sedation. Use Caution/Monitor.

            • maraviroc

              maraviroc, amoxapine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.

            • marijuana

              amoxapine and marijuana both increase sedation. Use Caution/Monitor.

            • meclizine

              meclizine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • melatonin

              amoxapine and melatonin both increase sedation. Use Caution/Monitor.

            • meperidine

              meperidine and amoxapine both increase sedation. Use Caution/Monitor.

            • meprobamate

              amoxapine and meprobamate both increase sedation. Use Caution/Monitor.

            • metaproterenol

              amoxapine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaxalone

              metaxalone and amoxapine both increase sedation. Use Caution/Monitor.

            • methadone

              amoxapine and methadone both increase QTc interval. Modify Therapy/Monitor Closely.

              methadone and amoxapine both increase sedation. Use Caution/Monitor.

            • methamphetamine

              amoxapine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methocarbamol

              methocarbamol and amoxapine both increase sedation. Use Caution/Monitor.

            • methscopolamine

              methscopolamine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              amoxapine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methylphenidate

              amoxapine, methylphenidate. Other (see comment). Use Caution/Monitor. 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

              amoxapine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              metoclopramide and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

            • midazolam

              midazolam and amoxapine both increase sedation. Use Caution/Monitor.

            • midazolam intranasal

              midazolam intranasal, amoxapine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

            • midodrine

              amoxapine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • mifepristone

              mifepristone, amoxapine. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

            • mirabegron

              mirabegron will increase the level or effect of amoxapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • mirtazapine

              amoxapine and mirtazapine both increase sedation. Use Caution/Monitor.

              amoxapine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • modafinil

              amoxapine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • morphine

              morphine and amoxapine both increase sedation. Use Caution/Monitor.

              amoxapine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • motherwort

              amoxapine and motherwort both increase sedation. Use Caution/Monitor.

            • moxonidine

              amoxapine and moxonidine both increase sedation. Use Caution/Monitor.

            • nabilone

              amoxapine and nabilone both increase sedation. Use Caution/Monitor.

            • nalbuphine

              nalbuphine and amoxapine both increase sedation. Use Caution/Monitor.

            • naratriptan

              naratriptan and amoxapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • nefopam

              nefopam, amoxapine. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.

            • neostigmine

              neostigmine increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • norepinephrine

              amoxapine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amoxapine increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor.

            • nortriptyline

              amoxapine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and nortriptyline both increase sedation. Use Caution/Monitor.

            • ofloxacin

              amoxapine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • olanzapine

              olanzapine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              olanzapine and amoxapine both increase sedation. Use Caution/Monitor.

            • oliceridine

              amoxapine, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.

              amoxapine increases toxicity of oliceridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.

            • olodaterol inhaled

              amoxapine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

            • onabotulinumtoxinA

              onabotulinumtoxinA and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • opium tincture

              opium tincture and amoxapine both increase sedation. Use Caution/Monitor.

            • orphenadrine

              amoxapine and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              orphenadrine and amoxapine both increase sedation. Use Caution/Monitor.

            • osimertinib

              osimertinib and amoxapine both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

            • oxaliplatin

              oxaliplatin will increase the level or effect of amoxapine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

            • oxazepam

              oxazepam and amoxapine both increase sedation. Use Caution/Monitor.

            • oxybutynin

              oxybutynin and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxybutynin topical

              oxybutynin topical and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxybutynin transdermal

              oxybutynin transdermal and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • oxycodone

              oxycodone and amoxapine both increase sedation. Use Caution/Monitor.

            • oxymetazoline intranasal

              amoxapine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

            • oxymorphone

              oxymorphone and amoxapine both increase sedation. Use Caution/Monitor.

            • ozanimod

              ozanimod and amoxapine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

            • paliperidone

              paliperidone and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              amoxapine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              paliperidone and amoxapine both increase sedation. Use Caution/Monitor.

            • pancuronium

              pancuronium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • papaveretum

              papaveretum and amoxapine both increase sedation. Use Caution/Monitor.

            • papaverine

              amoxapine and papaverine both increase sedation. Use Caution/Monitor.

            • paroxetine

              amoxapine and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.

            • pasireotide

              amoxapine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

            • pazopanib

              amoxapine and pazopanib both increase QTc interval. Use Caution/Monitor.

            • peginterferon alfa 2b

              peginterferon alfa 2b, amoxapine. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.

            • pentazocine

              pentazocine and amoxapine both increase sedation. Use Caution/Monitor.

              amoxapine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • pentobarbital

              pentobarbital and amoxapine both increase sedation. Use Caution/Monitor.

            • perphenazine

              perphenazine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              perphenazine and amoxapine both increase sedation. Use Caution/Monitor.

            • phendimetrazine

              amoxapine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenobarbital

              phenobarbital and amoxapine both increase sedation. Use Caution/Monitor.

            • phentermine

              amoxapine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine

              amoxapine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine ophthalmic

              amoxapine, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. 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 PO

              amoxapine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • pholcodine

              amoxapine and pholcodine both increase sedation. Use Caution/Monitor.

            • physostigmine

              physostigmine increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pilocarpine

              pilocarpine increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pilocarpine ophthalmic

              pilocarpine ophthalmic increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pimozide

              pimozide and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              pimozide and amoxapine both increase sedation. Use Caution/Monitor.

            • pirbuterol

              amoxapine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • posaconazole

              amoxapine and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • pralidoxime

              pralidoxime and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • pregabalin

              pregabalin, amoxapine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • primidone

              primidone and amoxapine both increase sedation. Use Caution/Monitor.

            • prochlorperazine

              prochlorperazine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              prochlorperazine and amoxapine both increase QTc interval. Use Caution/Monitor.

              prochlorperazine and amoxapine both increase sedation. Use Caution/Monitor.

            • promethazine

              promethazine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              promethazine and amoxapine both increase QTc interval. Use Caution/Monitor.

              promethazine and amoxapine both increase sedation. Use Caution/Monitor.

            • propantheline

              propantheline and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • propofol

              propofol and amoxapine both increase sedation. Use Caution/Monitor.

            • propylhexedrine

              amoxapine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • protriptyline

              amoxapine and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and protriptyline both increase sedation. Use Caution/Monitor.

            • pyridostigmine

              pyridostigmine increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • quazepam

              quazepam and amoxapine both increase sedation. Use Caution/Monitor.

            • quetiapine

              quetiapine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              quetiapine and amoxapine both increase sedation. Use Caution/Monitor.

              quetiapine, amoxapine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

            • quinine

              amoxapine and quinine both increase QTc interval. Use Caution/Monitor.

            • ramelteon

              amoxapine and ramelteon both increase sedation. Use Caution/Monitor.

            • ranolazine

              amoxapine and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

            • rapacuronium

              rapacuronium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • remimazolam

              remimazolam, amoxapine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

            • rifabutin

              rifabutin decreases levels of amoxapine by increasing metabolism. Use Caution/Monitor.

            • rilpivirine

              rilpivirine increases toxicity of amoxapine by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.

            • risperidone

              amoxapine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              risperidone and amoxapine both increase sedation. Use Caution/Monitor.

            • rizatriptan

              rizatriptan and amoxapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • rocuronium

              rocuronium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • rolapitant

              rolapitant will increase the level or effect of amoxapine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.

            • romidepsin

              amoxapine and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.

            • salmeterol

              amoxapine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • SAMe

              amoxapine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

            • scopolamine

              scopolamine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • scullcap

              amoxapine and scullcap both increase sedation. Use Caution/Monitor.

            • secobarbital

              secobarbital and amoxapine both increase sedation. Use Caution/Monitor.

            • selpercatinib

              selpercatinib increases toxicity of amoxapine by QTc interval. Use Caution/Monitor.

            • shepherd's purse

              amoxapine and shepherd's purse both increase sedation. Use Caution/Monitor.

            • sodium sulfate/?magnesium sulfate/potassium chloride

              sodium sulfate/?magnesium sulfate/potassium chloride increases effects of amoxapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

            • sodium sulfate/potassium sulfate/magnesium sulfate

              sodium sulfate/potassium sulfate/magnesium sulfate increases effects of amoxapine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.

            • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

              amoxapine, sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.

            • solifenacin

              solifenacin and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • sorafenib

              sorafenib and amoxapine both increase QTc interval. Use Caution/Monitor.

            • stiripentol

              stiripentol, amoxapine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

            • succinylcholine

              succinylcholine increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sufentanil

              sufentanil and amoxapine both increase sedation. Use Caution/Monitor.

            • sufentanil SL

              sufentanil SL, amoxapine. 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.

            • sulfamethoxazole

              amoxapine and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • sumatriptan

              sumatriptan and amoxapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • sumatriptan intranasal

              sumatriptan intranasal and amoxapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • suvorexant

              suvorexant and amoxapine both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary

            • tapentadol

              tapentadol and amoxapine both increase sedation. Use Caution/Monitor.

              amoxapine and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.

            • telavancin

              amoxapine and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.

            • temazepam

              temazepam and amoxapine both increase sedation. Use Caution/Monitor.

            • terbinafine

              terbinafine will increase the level or effect of amoxapine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.

            • terbutaline

              amoxapine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tetrabenazine

              amoxapine and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

            • thioridazine

              thioridazine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              thioridazine and amoxapine both increase sedation. Use Caution/Monitor.

            • thiothixene

              thiothixene and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              thiothixene and amoxapine both increase sedation. Use Caution/Monitor.

            • tiotropium

              tiotropium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • tolterodine

              tolterodine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • topiramate

              amoxapine and topiramate both increase sedation. Modify Therapy/Monitor Closely.

            • tramadol

              tramadol and amoxapine both increase sedation. Use Caution/Monitor.

              amoxapine and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.

            • trazodone

              amoxapine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and trazodone both increase sedation. Use Caution/Monitor.

            • triazolam

              triazolam and amoxapine both increase sedation. Use Caution/Monitor.

            • triclofos

              triclofos and amoxapine both increase sedation. Use Caution/Monitor.

            • trifluoperazine

              trifluoperazine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              trifluoperazine and amoxapine both increase sedation. Use Caution/Monitor.

            • trihexyphenidyl

              trihexyphenidyl and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.

            • trimethoprim

              amoxapine and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.

            • trimipramine

              amoxapine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              amoxapine and trimipramine both increase sedation. Use Caution/Monitor.

            • triprolidine

              triprolidine and amoxapine both increase sedation. Use Caution/Monitor.

            • tropisetron

              amoxapine and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.

            • trospium chloride

              trospium chloride and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • valerian

              valerian and amoxapine both increase sedation. Use Caution/Monitor.

            • vecuronium

              vecuronium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

            • venlafaxine

              amoxapine and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.

            • voclosporin

              voclosporin, amoxapine. Either increases effects of the other by QTc interval. Use Caution/Monitor.

            • voriconazole

              amoxapine and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • xylometazoline

              amoxapine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • yohimbine

              amoxapine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ziconotide

              amoxapine and ziconotide both increase sedation. Use Caution/Monitor.

            • ziprasidone

              ziprasidone and amoxapine both increase sedation. Use Caution/Monitor.

            • zolmitriptan

              zolmitriptan and amoxapine both increase serotonin levels. Modify Therapy/Monitor Closely.

            Minor (70)

            • acarbose

              amoxapine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

            • amobarbital

              amobarbital, amoxapine. Other (see comment). Minor/Significance Unknown. 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.

            • atropine

              amoxapine increases levels of atropine by unknown mechanism. Minor/Significance Unknown.

            • atropine IV/IM

              amoxapine increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.

            • bazedoxifene/conjugated estrogens

              bazedoxifene/conjugated estrogens, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • brimonidine

              amoxapine decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

            • butabarbital

              butabarbital, amoxapine. Other (see comment). Minor/Significance Unknown. 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.

            • butalbital

              butalbital, amoxapine. Other (see comment). Minor/Significance Unknown. 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.

            • carbamazepine

              carbamazepine decreases levels of amoxapine by increasing metabolism. Minor/Significance Unknown.

            • chlorpromazine

              amoxapine, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              amoxapine, chlorpromazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • chlorpropamide

              amoxapine increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.

            • conjugated estrogens

              conjugated estrogens, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • conjugated estrogens, vaginal

              conjugated estrogens, vaginal, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • desflurane

              desflurane, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

            • dexmethylphenidate

              dexmethylphenidate increases effects of amoxapine by decreasing metabolism. Minor/Significance Unknown.

            • estradiol

              estradiol, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • estrogens conjugated synthetic

              estrogens conjugated synthetic, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • estrogens esterified

              estrogens esterified, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens may inhibit hepatic metabolism of tricyclic antidepressants. However, interactions are not common.

            • estropipate

              estropipate, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • ethinylestradiol

              ethinylestradiol, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • etomidate

              etomidate, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

            • eucalyptus

              amoxapine and eucalyptus both increase sedation. Minor/Significance Unknown.

            • fluphenazine

              amoxapine, fluphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              amoxapine, fluphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

              fluphenazine, amoxapine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • glimepiride

              amoxapine increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.

            • glipizide

              amoxapine increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

            • glyburide

              amoxapine increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • hydroxyprogesterone caproate

              hydroxyprogesterone caproate, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • insulin aspart

              amoxapine increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin detemir

              amoxapine increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin glargine

              amoxapine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin glulisine

              amoxapine increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin lispro

              amoxapine increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin NPH

              amoxapine increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.

            • insulin regular human

              amoxapine increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.

            • isoproterenol

              isoproterenol, amoxapine. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

            • ketamine

              ketamine, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

            • lithium

              lithium, amoxapine. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.

            • mestranol

              mestranol, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • metformin

              amoxapine increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.

            • miglitol

              amoxapine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

            • nateglinide

              amoxapine increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.

            • panax ginseng

              panax ginseng increases effects of amoxapine by pharmacodynamic synergism. Minor/Significance Unknown.

            • pentobarbital

              pentobarbital, amoxapine. Other (see comment). Minor/Significance Unknown. 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.

            • perphenazine

              amoxapine, perphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              amoxapine, perphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • phenobarbital

              phenobarbital, amoxapine. Other (see comment). Minor/Significance Unknown. 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.

            • pioglitazone

              amoxapine increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

            • pleurisy root

              pleurisy root decreases effects of amoxapine by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.

            • primidone

              primidone, amoxapine. Other (see comment). Minor/Significance Unknown. 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.

            • prochlorperazine

              amoxapine, prochlorperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              amoxapine, prochlorperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • progesterone micronized

              progesterone micronized, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

            • promazine

              amoxapine, promazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              amoxapine, promazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • promethazine

              amoxapine, promethazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              amoxapine, promethazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

              promethazine, amoxapine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • propofol

              propofol, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

            • repaglinide

              amoxapine increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.

            • risperidone

              risperidone and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Minor/Significance Unknown.

            • rosiglitazone

              amoxapine increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

            • sage

              amoxapine and sage both increase sedation. Minor/Significance Unknown.

            • saxagliptin

              amoxapine increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

            • secobarbital

              secobarbital, amoxapine. Other (see comment). Minor/Significance Unknown. 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.

            • sevoflurane

              sevoflurane, amoxapine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

            • sitagliptin

              amoxapine increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

            • sulfamethoxazole

              sulfamethoxazole decreases levels of amoxapine by unspecified interaction mechanism. Minor/Significance Unknown.

            • thioridazine

              amoxapine, thioridazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              amoxapine, thioridazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • tolazamide

              amoxapine increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.

            • tolbutamide

              amoxapine increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.

            • trifluoperazine

              amoxapine, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              amoxapine, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • vasopressin

              amoxapine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.

            • verapamil

              verapamil increases levels of amoxapine by decreasing metabolism. Minor/Significance Unknown.

            • vildagliptin

              amoxapine increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

            • zolpidem

              zolpidem, amoxapine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

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            Adverse Effects

            >10%

            Constipation (12-14%)

            Dry mouth (12-14%)

            Sedation (12-14%)

            1-10%

            Anxiety

            Ataxia

            Blurred vision

            Confusion

            Dizziness

            Edema

            Headache

            Fatigue

            Nausea

            Nervousness/restlessness

            Prolactin levels increased

            Rash

            Sweating

            Tremor

            Weakness

            <1%

            Agranulocytosis

            Diarrhea

            ECG changes

            EPS

            Flatulence

            Galactorrhea

            Hypertension

            Leukopenia

            Menstrual irregularity

            Mydriasis

            Orthostatic hypotension

            Seizure

            Urinary retention

            Urticaria

            Vomiting

            Tachycardia

            Sexual dysfunction

            Frequency Not Defined

            neuroleptic malignant syndrome (rare)

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            Warnings

            Black Box Warnings

            In short-term studies, antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 yr of age) taking antidepressants for major depressive disorders and other psychiatric illnesses

            This increase was not seen in patients aged >24 years; a slight decrease in suicidal thinking was seen in adults >65 years

            In children and young adults, risks must be weighed against the benefits of taking antidepressants

            Patients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies; this should be done during initial 1-2 months of therapy and dosage adjustments

            The patient’s family should communicate any abrupt changes in behavior to the healthcare provider

            Worsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapy

            This drug is not approved for use in pediatric patients

            Contraindications

            Hypersensitivity

            Severe cardiovascular d/o

            Uncorrected narrow angle glaucoma

            Within 14 day of MAOIs (risk of serotonin syndrome); if linezolid or IV methylene blue (MAOIs) must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity; may resume 24 hr after last linezolid or methylene blue dose, or after 2 weeks of monitoring, whichever comes first

            Any drugs or conditions that prolong QT interval

            Acute recovery post-MI

            Cautions

            BPH, urinary/GI retention, incr IOP, hyperthyroidism, opne angle glaucoma, seizure d/o, brain tumor, respiratory impairment, hyperthyroidism

            Clinical worsening & suicide ideation may occur despite medication in adolescents & young adults (18-24 yo)

            Risk of anticholinergic side effects

            Possibility of tardive dyskinesia & NMS

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: enters breast milk; use with caution

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Neurotransmitter (esp NE & serotonin) reuptake inhibitor; anticholinergic

            Pharmacokinetics

            Half-Life: 8-30 hr

            Peak Plasma Time: 90 min

            Bioavailability: Almost complete absorption

            Metabolites: 8-hydroxyamoxapine

            Vd: 0.9-1.2 L/kg

            Protein binding: 90%

            Excretion: Urine (60%); Feces: (18%)

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            amoxapine oral
            -
            150 mg tablet
            amoxapine oral
            -
            100 mg tablet
            amoxapine oral
            -
            50 mg tablet
            amoxapine oral
            -
            25 mg tablet

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            amoxapine oral

            AMOXAPINE - ORAL

            (a-MOX-a-peen)

            COMMON BRAND NAME(S): Asendin

            WARNING: Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

            USES: This medication is used to treat depression. Treating depression can improve your mood and sense of well-being and allow you to enjoy everyday life more.Amoxapine is a tricyclic antidepressant. It works by restoring the balance of natural chemicals (neurotransmitters) in the brain. Because amoxapine has some effects that are similar to those of major tranquilizers, it may work better in patients who have agitation or anxiety along with depression.

            HOW TO USE: Read the Medication Guide if one is available from your pharmacist. Consult your doctor or pharmacist if you have any questions.Take this medication by mouth with or without food, one or more time(s) daily. To lessen side effects, amoxapine may be started at a low dose and slowly increased as your body gets used to it. Follow your doctor's instructions carefully. After you have reached the best dose for you, the total dose (when the daily dose is 300 milligrams or less) can be taken once daily, usually at bedtime to prevent daytime drowsiness, or as directed by your doctor. Your dosage is based on your medical condition, age, and your response to therapy.Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day. This medication does not work right away. It may take up to two weeks before you experience the full benefits.Keep taking this medication even if you feel well. Do not suddenly stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased.Inform your doctor if your condition does not improve or if it worsens.

            SIDE EFFECTS: See also the Warning section.Drowsiness, dizziness, difficulty urinating, dry mouth, constipation, headache, weakness, blurred vision, or changes in appetite/weight may occur as your body gets used to the medication. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water or use a saliva substitute. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: dizziness/fainting, feelings of restlessness, mental/mood changes (e.g., confusion, depression, hallucinations, nervousness), numbness/tingling of the hands/feet, ringing in the ears, shakiness (tremors), stomach/abdominal pain, severe vomiting/constipation.Get medical help right away if you have any very serious side effects, including: chest pain, jaw/left arm pain, slow/fast/irregular heartbeat, pain/redness/swelling of arms/legs, seizures, severe headache, weakness on one side of the body, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night), trouble speaking.In rare instances, this medication may increase your level of a certain natural chemical made by the body (prolactin). For females, this increase in prolactin may result in unwanted breast milk, missing/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away.This drug may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any unusual/uncontrolled movements (especially of the face, mouth, tongue, arms or legs).Amoxapine may rarely cause a serious condition called neuroleptic malignant syndrome. Seek immediate medical attention if you develop the following: fever, muscle stiffness, increased sweating, fast/irregular heartbeat, severe confusion.This medication may rarely cause serious blood problems (e.g., agranulocytosis, thrombocytopenia) or liver problems. Seek immediate medical attention if you notice any of the following rare but very serious side effects: easy bleeding/bruising, signs of infection (e.g., fever, persistent sore throat), severe stomach/abdominal pain, dark urine, yellowing of the eyes/skin.A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: See also the Warning section.Before taking amoxapine, tell your doctor or pharmacist if you are allergic to it; or to other tricyclic antidepressants (e.g., amitriptyline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood problems (e.g., agranulocytosis, thrombocytopenia), breathing problems (e.g., asthma, COPD), personal or family history of glaucoma (angle-closure type), intestinal problems (e.g., chronic constipation, ileus), heart problems (e.g., recent heart attack, arrhythmias, coronary artery disease, heart failure), kidney problems, liver problems, other mental/mood conditions (e.g., bipolar disorder, psychosis), family history of mental/mood conditions (e.g., bipolar disorder) or suicide, history of neuroleptic malignant syndrome, movement disorders (e.g., Parkinson's disease, tardive dyskinesia), overactive thyroid (hyperthyroidism), problems urinating (urinary retention, enlarged prostate), seizures, conditions that may increase your risk of seizures (e.g., electroshock therapy, stroke, alcohol withdrawal).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).To minimize the dizziness and lightheadedness, get up slowly when rising from a seated or lying position.Before having surgery, tell your doctor or dentist that you are taking this medication.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Older adults may be more sensitive to the side effects of this drug, especially drowsiness, dizziness, confusion, constipation, trouble urinating, and involuntary movements (tardive dyskinesia). Drowsiness, dizziness, and confusion can increase the risk of falling.This medication should be used only when clearly needed during pregnancy. Infants born to mothers who have taken similar medications during pregnancy may have problems such as very deep sleep, trouble urinating, shaking (tremors), and seizures. Discuss the risks and benefits with your doctor.Since untreated mental/mood problems (such as depression, panic disorders, bipolar disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: anticholinergics (e.g., atropine, belladonna alkaloids), certain drugs for high blood pressure (e.g., clonidine, guanethidine), drugs for motion sickness (e.g., meclizine), psychiatric drugs (e.g., antipsychotics, antidepressants), thyroid supplements.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.This medication may interfere with certain medical/laboratory tests (including brain scan for Parkinson's disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Overdose of this medication may be fatal and symptoms include: seizures, delirium, and loss of consciousness .

            NOTES: Do not share this medication with others.Laboratory and/or medical tests may be performed periodically to monitor your progress or check for side effects. Keep all medical appointments so your doctor can monitor your progress closely or check for side effects. Consult your doctor for more details.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.