tryptophan (L-tryptophan) dosing, indications, interactions, adverse effects, and more

Sections

Sections L-tryptophan
Dosing & Uses
Interactions
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout

Dosing & Uses

AdultPediatric

Depression

8-12 g/d PO divided QID/TID

Lower dosage effective in combination with other antidepressants

Administration

Take with low-protein, carbohydrate-rich meals or snacks

Safety and efficacy not established

Interaction Checker

Enter a drug name and L-tryptophan

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Serious - Use Alternative

Significant - Monitor Closely

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Contraindicated (0)

Serious - Use Alternative (9)

citalopram
citalopram and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.
desvenlafaxine
L-tryptophan and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.
isocarboxazid
isocarboxazid and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug.
linezolid
linezolid and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.
lorcaserin
L-tryptophan and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.
methylene blue
methylene blue and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.
phenelzine
phenelzine and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug.
tranylcypromine
tranylcypromine and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug.
vilazodone
L-tryptophan, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant use is not recommended.

Monitor Closely (53)

5-HTP
5-HTP and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
almotriptan
almotriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
amitriptyline
amitriptyline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
amoxapine
amoxapine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
buspirone
buspirone and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
clomipramine
clomipramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
cocaine
cocaine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
desipramine
desipramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
dexfenfluramine
dexfenfluramine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
dextroamphetamine
dextroamphetamine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
dextromethorphan
dextromethorphan and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
dihydroergotamine
dihydroergotamine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
dihydroergotamine intranasal
dihydroergotamine intranasal and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
doxepin
doxepin and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
duloxetine
duloxetine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
eletriptan
eletriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
ergotamine
ergotamine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
escitalopram
escitalopram and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
fenfluramine
fenfluramine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
fluoxetine
fluoxetine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
fluvoxamine
fluvoxamine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
frovatriptan
frovatriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
imipramine
imipramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
isoniazid
isoniazid and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
levomilnacipran
levomilnacipran and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
lithium
L-tryptophan and lithium both increase serotonin levels. Use Caution/Monitor.
lofepramine
lofepramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
lsd
L-tryptophan and lsd both increase serotonin levels. Use Caution/Monitor.
maprotiline
maprotiline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
meperidine
L-tryptophan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
milnacipran
milnacipran and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
mirtazapine
L-tryptophan and mirtazapine both increase serotonin levels. Use Caution/Monitor.
morphine
L-tryptophan and morphine both increase serotonin levels. Use Caution/Monitor.
naratriptan
naratriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
nefazodone
nefazodone and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
nortriptyline
nortriptyline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
paroxetine
paroxetine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
pentazocine
L-tryptophan and pentazocine both increase serotonin levels. Use Caution/Monitor.
protriptyline
protriptyline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
rasagiline
rasagiline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
rizatriptan
rizatriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
SAMe
L-tryptophan and SAMe both increase serotonin levels. Use Caution/Monitor.
selegiline
selegiline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
selegiline transdermal
selegiline transdermal and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
sertraline
sertraline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
St John's Wort
L-tryptophan and St John's Wort both increase serotonin levels. Modify Therapy/Monitor Closely.
sumatriptan
sumatriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
sumatriptan intranasal
sumatriptan intranasal and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
tramadol
L-tryptophan and tramadol both increase serotonin levels. Use Caution/Monitor.
trazodone
trazodone and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
trimipramine
trimipramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
venlafaxine
venlafaxine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
zolmitriptan
zolmitriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.

Minor (0)

5-HTP
Monitor Closely (1)5-HTP and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
almotriptan
Monitor Closely (1)almotriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
amitriptyline
Monitor Closely (1)amitriptyline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
amoxapine
Monitor Closely (1)amoxapine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
buspirone
Monitor Closely (1)buspirone and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
citalopram
Serious - Use Alternative (1)citalopram and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.
clomipramine
Monitor Closely (1)clomipramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
cocaine
Monitor Closely (1)cocaine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
desipramine
Monitor Closely (1)desipramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
desvenlafaxine
Serious - Use Alternative (1)L-tryptophan and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.
dexfenfluramine
Monitor Closely (1)dexfenfluramine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
dextroamphetamine
Monitor Closely (1)dextroamphetamine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
dextromethorphan
Monitor Closely (1)dextromethorphan and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
dihydroergotamine
Monitor Closely (1)dihydroergotamine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
dihydroergotamine intranasal
Monitor Closely (1)dihydroergotamine intranasal and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
doxepin
Monitor Closely (1)doxepin and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
duloxetine
Monitor Closely (1)duloxetine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
eletriptan
Monitor Closely (1)eletriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
ergotamine
Monitor Closely (1)ergotamine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
escitalopram
Monitor Closely (1)escitalopram and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
fenfluramine
Monitor Closely (1)fenfluramine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
fluoxetine
Monitor Closely (1)fluoxetine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
fluvoxamine
Monitor Closely (1)fluvoxamine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
frovatriptan
Monitor Closely (1)frovatriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
imipramine
Monitor Closely (1)imipramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
isocarboxazid
Serious - Use Alternative (1)isocarboxazid and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug.
isoniazid
Monitor Closely (1)isoniazid and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
levomilnacipran
Monitor Closely (1)levomilnacipran and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
linezolid
Serious - Use Alternative (1)linezolid and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.
lithium
Monitor Closely (1)L-tryptophan and lithium both increase serotonin levels. Use Caution/Monitor.
lofepramine
Monitor Closely (1)lofepramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
lorcaserin
Serious - Use Alternative (1)L-tryptophan and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.
lsd
Monitor Closely (1)L-tryptophan and lsd both increase serotonin levels. Use Caution/Monitor.
maprotiline
Monitor Closely (1)maprotiline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
meperidine
Monitor Closely (1)L-tryptophan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
methylene blue
Serious - Use Alternative (1)methylene blue and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.
milnacipran
Monitor Closely (1)milnacipran and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
mirtazapine
Monitor Closely (1)L-tryptophan and mirtazapine both increase serotonin levels. Use Caution/Monitor.
morphine
Monitor Closely (1)L-tryptophan and morphine both increase serotonin levels. Use Caution/Monitor.
naratriptan
Monitor Closely (1)naratriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
nefazodone
Monitor Closely (1)nefazodone and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
nortriptyline
Monitor Closely (1)nortriptyline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
paroxetine
Monitor Closely (1)paroxetine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
pentazocine
Monitor Closely (1)L-tryptophan and pentazocine both increase serotonin levels. Use Caution/Monitor.
phenelzine
Serious - Use Alternative (1)phenelzine and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug.
protriptyline
Monitor Closely (1)protriptyline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
rasagiline
Monitor Closely (1)rasagiline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
rizatriptan
Monitor Closely (1)rizatriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
SAMe
Monitor Closely (1)L-tryptophan and SAMe both increase serotonin levels. Use Caution/Monitor.
selegiline
Monitor Closely (1)selegiline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
selegiline transdermal
Monitor Closely (1)selegiline transdermal and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
sertraline
Monitor Closely (1)sertraline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
St John's Wort
Monitor Closely (1)L-tryptophan and St John's Wort both increase serotonin levels. Modify Therapy/Monitor Closely.
sumatriptan
Monitor Closely (1)sumatriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
sumatriptan intranasal
Monitor Closely (1)sumatriptan intranasal and L-tryptophan both increase serotonin levels. Use Caution/Monitor.
tramadol
Monitor Closely (1)L-tryptophan and tramadol both increase serotonin levels. Use Caution/Monitor.
tranylcypromine
Serious - Use Alternative (1)tranylcypromine and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug.
trazodone
Monitor Closely (1)trazodone and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
trimipramine
Monitor Closely (1)trimipramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
venlafaxine
Monitor Closely (1)venlafaxine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
vilazodone
Serious - Use Alternative (1)L-tryptophan, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant use is not recommended.
zolmitriptan
Monitor Closely (1)zolmitriptan and L-tryptophan both increase serotonin levels. Use Caution/Monitor.

Frequency Not Defined

Anorexia

Dizziness

Dry mouth

Headache

Nausea

Sexual disinhibition

Contraindications

Hypersensivity

Cautions

Bladder cancer

Diabetes mellitus

Achlorhydria/malabsorption

Cataract formation

Some bipolar pts are acutely sensitive & would not tolerate dosage >1-2 g/d

Clinical worsening & suicide ideation may occur despite medication

Pregnancy & Lactation

Pregnancy Category: C

Lactation: avoid during breastfeeding

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Pharmacology

Metabolism: Converted to nicotinic acid & serotonin as well as incorporated into proteins

Excretion: N/A

Mechanism of Action

Incr serotonin synthesis

Images

No images available for this drug.

Patient Handout

A Patient Handout is not currently available for this monograph.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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