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

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Serious - Use Alternative

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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 (54)

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.
dextroamphetamine transdermal
L-tryptophan, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).
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.
dextroamphetamine transdermal
Monitor Closely (1)L-tryptophan, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).
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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