Amitriptyline and Revumenib: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Amitriptyline
Revumenib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Both of these medicines can affect your heart's rhythm. Amitriptyline (Elavil), an older antidepressant, and revumenib (Revuforj), a cancer medicine, can each stretch out a part of your heartbeat called the QT interval. When you take them together, that effect can add up and, in rare cases, lead to a dangerous irregular heartbeat.
Please don't stop or change either medicine on your own. This is something your care team knows how to handle. They can check your heart with an ECG, keep an eye on your blood minerals like potassium, and adjust things safely. Call your doctor right away if you feel fainting, dizziness, or a pounding, fluttering heartbeat.
Interaction: Additive QTc prolongation when amitriptyline is combined with revumenib. Both agents independently prolong the QT interval (amitriptyline is a well-known TCA-associated QT risk; revumenib carries labeled QTc warnings).
- Mechanism: Pharmacodynamic, additive QTc prolongation (no enzyme/transporter basis here).
- Direction/magnitude: Increased torsadogenic risk; magnitude not quantified.
- Evidence: Theoretical; severity major.
- Management: Correct electrolytes (K+, Mg2+) before revumenib. ECG weekly for first 4 weeks, then monthly. Interrupt revumenib if QTcF >480 to 60 msec above baseline (resume at lower dose). Permanently discontinue for ventricular arrhythmia or symptomatic QTc prolongation.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
Do not use revumenib together with agents recognized for prolonging the QTc interval, since this combination can heighten the likelihood of QT interval prolongation. Before starting revumenib, correct any electrolyte abnormalities. Obtain an ECG no less than once weekly during the initial 4 weeks of therapy, and thereafter at a minimum of once per month. Should the QTcF rise above 480 msec but stay below 500 msec, hold revumenib, then resume it at the same twice daily dose once the QTcF interval has returned to 480 msec or less. If the QTcF exceeds 500 msec or increases by more than 60 msec relative to baseline, interrupt revumenib and, after the QTcF interval falls back to 480 msec or less, restart it twice daily at the reduced dose level. Discontinue revumenib permanently in patients experiencing ventricular arrhythmias as well as in those who develop QTc interval prolongation accompanied by signs or symptoms of a life threatening arrhythmia1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
The good news: your care team has clear ways to manage this safely.
- Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise.
- Your team may check and correct blood minerals (like potassium and magnesium) before and during revumenib.
- Expect regular ECGs, often weekly for the first month and then monthly, to watch your heart rhythm.
- Your revumenib dose may be paused or adjusted and individualized based on your ECG results.
- Ask your pharmacist or doctor whether a different antidepressant with less heart-rhythm effect might suit you.
Seek care urgently for fainting, palpitations, or severe dizziness.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) During the clinical trials, prolongation of the QTc interval was recorded as an adverse reaction in 39 (29%) of 135 patients who received revumenib at the recommended dose for relapsed or refractory acute leukemia carrying a KMT2A translocation; this QTc interval prolongation reached Grade 3 in 12%. The heart-rate corrected QT interval calculated with Fridericia's method (QTcF) exceeded 500 msec in 8%, and the rise from baseline QTcF was over 60 msec in 18%. A revumenib dose reduction was necessary in 5% because of QTc interval prolongation. QTc prolongation was seen in 16% of the 31 patients younger than 17 years, 33% of the 88 patients aged 17 years to under 65 years, and 50% of the 16 patients 65 years or older 1.
Common questions
Can I take Amitriptyline and Revumenib together?
Amitriptyline and revumenib can both prolong the QT interval, so taking them together raises the risk of a dangerous heart rhythm; your care team will monitor with ECGs, correct electrolytes, and may adjust doses. Keep taking both as prescribed and report any fainting or palpitations right away. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amitriptyline and Revumenib interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Amitriptyline and Revumenib interaction managed?
The good news: your care team has clear ways to manage this safely. Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise. Your team may check and correct blood minerals (like potassium and magnesium) before and during revumenib. Expect regular ECGs, often weekly for the first month and then monthly, to watch your heart rhythm. Your revumenib dose may be pause… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Amitriptyline or Revumenib need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: REVUFORJ oral tablets, revumenib oral tablets. Syndax Pharmaceuticals, Inc. (per FDA), Waltham, MA, 2024. DailyMed
Keep reading about Amitriptyline
Keep reading about Revumenib
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