Butriptyline

Recent MI, arrhythmias, severe liver disease, manic phase. Lactation.

CV disease, history of epilepsy, hepatic impairment, hyperthyroidism, pheochromocytoma, history of mania, psychoses, close-angle glaucoma, history of urinary retention, concurrent electroconvulsive therapy, diabetes. Pregnancy. Elderly and child. Porphyria. Avoid abrupt withdrawal. May cause drowsiness; do not drive or operate machinery.

Marked antimuscarinic effects, CV effects. Nausea, sweating, tremor, hypersensitivity reactions, behavioral disturbances, sexual dysfunction, blood sugar changes, increased appetite or wt gain. Testicular enlargement, gynecomastia, galactorrhea. Convulsion, movement disorders, dyskinesias. Fever and blood disorders.

Plasma conc and effects may be enhanced by concomitant use of cimetidine, diltiazem, disulfiram, methylphenidate, ritonavir and verapamil. Side-effects may be increased by adrenaline, amiodarone, general anesthetics, SSRIs, antihistamines, antimuscarinics, antipsychotics, anxiolytics and hypnotics, clozapine, disopyramide, diuretics, flecainide, MAOIs, moclobemide, moxifloxacin, nefopam, nicorandil, noradrenaline,phenothiazine, pimozide, procainamide, propafenone, quinidine, selegiline, sibutramine, sotalol, terfenadine, thioridazine and tramadol. Clonidine, barbiturates, nitrates and primidone are reduced while effects of baclofen, opioid analgesics and thyroid hormones are enhanced with concomitant use. Carbamazepine and rifampicin may increase metabolism while its effects may be antagonized by estrogens. Alcohol.
Potentially Fatal: Concomitant use with brimonidine, entacapone, artemether with lumefantrine or sibutramine should be avoided.

Description:
Mechanism of Action: Butriptyline, similar to amitriptyline, exert its antidepressant action by blocking the neuronal re-uptake of noradrenaline and serotonin. It is one of the less sedating tricyclics.

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