Amitriptyline
Adverse Effect: Attenuation of antidepressant effectiveness; tricyclic toxicity (drowsiness, hypotension, akathisia) Clinical Management: If signs or symptoms of altered tricyclic response are noted, dose adjustment downward of either Tibolone or Amitriptyline may be successful in restoring effectiveness or resolving toxicity. However, drug withdrawal may be required.
Amoxapine
Adverse Effect: Attenuation of antidepressant effectiveness; Amoxapine toxicity (drowsiness, hypotension, akathisia) Clinical Management: If signs or symptoms of altered Amoxapine response is noted, dose adjustment downward of either Tibolone or Amoxapine may be successful in restoring effectiveness or resolving toxicity. However, drug withdrawal may be required.
Chlordiazepoxide
Adverse Effect: Attenuation of antidepressant effectiveness; tricyclic toxicity (drowsiness, hypotension, akathisia) Clinical Management: If signs or symptoms of altered tricyclic response are noted, dose adjustment downward of either Tibolone or Chlordiazepoxide may be successful in restoring effectiveness or resolving toxicity. However, drug withdrawal may be required.
Clomipramine
Adverse Effect: Attenuation of antidepressant effectiveness; tricyclic toxicity (drowsiness, hypotension, akathisia) Clinical Management: If signs or symptoms of altered tricyclic response are noted, dose adjustment downward of either Tibolone or Clomipramine may be successful in restoring effectiveness or resolving toxicity. However, drug withdrawal may be required.
Dothiepin
Adverse Effect: Attenuation of antidepressant effectiveness; tricyclic toxicity (drowsiness, hypotension, akathisia) Clinical Management: If signs or symptoms of altered tricyclic response are noted, dose adjustment downward of either Tibolone or Dothiepin may be successful in restoring effectiveness or resolving toxicity. However, drug withdrawal may be required.
Doxepin
Adverse Effect: Attenuation of antidepressant effectiveness; tricyclic toxicity (drowsiness, hypotension, akathisia) Clinical Management: If signs or symptoms of altered tricyclic response are noted, dose adjustment downward of either Tibolone or Doxepin may be successful in restoring effectiveness or resolving toxicity. However, drug withdrawal may be required.
Imipramine
Adverse Effect: Attenuation of antidepressant effectiveness; tricyclic toxicity (drowsiness, hypotension, akathisia) Clinical Management: If signs or symptoms of altered tricyclic response are noted, dose adjustment downward of either the Tibolone or Imipramine may be successful in restoring effectiveness or resolving toxicity. However, drug withdrawal may be required.
Nortriptyline
Adverse Effect: Attenuation of antidepressant effectiveness; tricyclic toxicity (drowsiness, hypotension, akathisia) Clinical Management: If signs or symptoms of altered tricyclic response are noted, dose adjustment downward of either the Tibolone or Nortriptyline may be successful in restoring effectiveness or resolving toxicity. However, drug withdrawal may be required.
Trimipramine
Adverse Effect: Attenuation of antidepressant effectiveness; tricyclic toxicity (drowsiness, hypotension, akathisia) Clinical Management: If signs or symptoms of altered tricyclic response are noted, dose adjustment downward of either Tibolone or Trimipramine may be successful in restoring effectiveness or resolving toxicity. However, drug withdrawal may be required.
Warfarin
Adverse Effect: decreased anticoagulant effectiveness Clinical Management: Increased monitoring of clotting times is not indicated in patients receiving tibolone and warfarin concurrently. Clinical evidence of hypercoagulability, including recurrent thrombosis, in patients on warfarin may require discontinuation of estrogen therapy and/or a higher level of anticoagulation |