Selected Tricyclic Antidepressants/Quinidine; Thioridazine Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Quinidine or thioridazine may slow down how quickly your body processes medicines in the tricyclic antidepressant family: amitriptyline, clomipramine, desipramine, doxepin, imipramine or nortriptyline.

What might happen:

The blood levels of your tricyclic medicine may increase and could cause side effects.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. If you experience weakness, tiredness, dizziness, light headedness, confusion, nervousness, difficulty sleeping, blurred vision, severe constipation, or problems urinating, contact your doctor as soon as possible. It may be necessary to adjust the dose or change one of your medicines.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Thioridazine tablet, US prescribing information. Mutual Pharmaceutical September, 2014.
  • 2.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and- drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
  • 3.LLerena A, Berecz R, de la Rubia A, Fernandez-Salguero P, Dorado P. Effect of thioridazine dosage on the debrisoquine hydroxylation phenotype in psychiatric patients with different CYP2D6 genotypes. Ther Drug Monit 2001 Dec;23(6):616-20.
  • 4.Amitriptyline hydrochloride, US prescribing information. Sandoz Inc. January, 2010.
  • 5.Pamelor (nortriptyline hydrochloride) US prescribing information. Mallinckrodt Inc. October, 2012.
  • 6.Nuedexta (dextromethorphan hydrobromide and quinidine sulfate) US prescribing information. Avanir Pharmaceuticals June, 2019.
  • 7.FDA Drug Approval Package application: 021879. Nuedexta (dextromethorphan hydrobromide and quinidine sulfate), Clinical Pharmacology and Biopharmaceutics Reviews. URL: http://www.accessdata.fda.gov/drugsatfda_docs/nda/2010/021879Orig1s000Clin PharmR.pdf 10/29/2010.
  • 8.American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2023 Jul;71(7):2052-2081.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.