Ziftomenib and Amitriptyline: 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
Ziftomenib
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 ziftomenib (Komzifti), 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.
This concern is based on how the drugs work rather than lots of real-world reports, so try not to worry. Your care team can manage this safely, often by checking your heart with an EKG and keeping a close eye on you. Please talk with your doctor or pharmacist before changing anything.
Effect: Additive QTc prolongation, increasing the risk of torsade de pointes and other serious arrhythmias.
Mechanism: Pharmacodynamic (additive), not metabolic. Both agents independently prolong the QTc interval. Neither is a prodrug in this context.
Evidence: Theoretical; onset unspecified; severity major.
- Avoid coadministration where possible.
- If unavoidable, obtain ECGs at initiation, during concomitant use, and as clinically indicated.
- Interrupt ziftomenib if QTc greater than 500 ms or change from baseline greater than 60 ms.
- Correct electrolytes (K+, Mg2+) and review other QT-prolonging agents.
What happens
An increased risk of QT interval prolongation and torsade de pointes
Interaction Deep Dive
Do not administer ziftomenib together with other agents recognized for their capacity to prolong the QTc interval. When such concurrent use is unavoidable, perform ECGs at the start of therapy, throughout the period of combined use, and whenever clinically warranted. Discontinue ziftomenib if the QTc interval exceeds 500 ms or if the increase from baseline exceeds 60 ms. Combining these drugs may additionally produce adverse effects linked to QTc interval prolongation, such as torsades de pointes, other serious arrhythmias, and sudden death1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Keep taking both medicines as prescribed unless your care team tells you otherwise. When two QT-prolonging drugs are used together, teams usually manage it carefully.
- Your team may prefer to avoid this combination and consider an alternative if one is available.
- If both are needed, expect EKGs when starting, during treatment, and whenever needed.
- Your ziftomenib may be paused if your EKG shows too much QT change.
Tell your pharmacist or doctor if you feel faint, dizzy, or have a racing or irregular heartbeat, and mention any other medicines you take.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Ziftomenib and Amitriptyline together?
Amitriptyline and ziftomenib can both prolong the QT interval, so combining them raises the risk of dangerous heart rhythms; your care team will usually avoid the pair or monitor you with EKGs. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ziftomenib and Amitriptyline 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 Ziftomenib and Amitriptyline interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. When two QT-prolonging drugs are used together, teams usually manage it carefully. Your team may prefer to avoid this combination and consider an alternative if one is available. If both are needed, expect EKGs when starting, during treatment, and whenever needed. Your ziftomenib may be paused if your EKG shows too… 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 Ziftomenib or Amitriptyline 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: KOMZIFTI™ oral capsules, ziftomenib oral capsules. Kura Oncology, Inc (per manufacturer), San Diego, CA, 2025. DailyMed
Keep reading about Amitriptyline
Keep reading about Ziftomenib
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist