Amitriptyline has 24 known drug interactions based on U.S. FDA drug labeling data. 7 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Clonidine Hydrochloride, Levothyroxine Sodium, Levothyroxine Sodium Anhydrous. Patients taking Amitriptyline should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 24
- Major
- 7
- Moderate
- 14
- Minor
- 2
Major (7)
- Amitriptyline + Clonidine Hydrochloride— Amitriptyline combined with clonidine enhances corneal lesion manifestation; reduces hypotensive effect of clonidine.
- Amitriptyline + Levothyroxine Sodium— Concurrent use may increase therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity …
- Amitriptyline + Levothyroxine Sodium Anhydrous— Concurrent use may increase therapeutic and toxic effects of both drugs, including increased risk of cardiac arrhythmias…
- Amitriptyline + Mirtazapine— Tricyclic antidepressant that increases risk of serotonin syndrome with mirtazapine. Monitor for symptoms during initiat…
- Amitriptyline + Norepinephrine Bitartrate— Co-administration can cause severe, prolonged hypertension. Monitor for hypertension if norepinephrine bitartrate cannot…
- Amitriptyline + Toremifene Citrate— Antidepressant that prolongs QT interval; should be avoided with toremifene citrate or requires close monitoring.
- Amitriptyline + Tramadol Hydrochloride— CYP2D6 inhibitor that increases tramadol concentrations and decreases M1 concentrations, increasing risk for serious adv…
Moderate (14)
- Amitriptyline + Buspirone Hydrochloride— No statistically significant differences in steady-state pharmacokinetic parameters observed when buspirone added to ami…
- Amitriptyline + Citalopram— Tricyclic antidepressants increase risk of serotonin syndrome when used with citalopram. Monitor for signs and symptoms …
- Amitriptyline + Citalopram Hydrobromide— Tricyclic antidepressants increase risk of serotonin syndrome when used concomitantly with citalopram. Monitor for signs…
- Amitriptyline + Clonidine— Amitriptyline in combination with clonidine enhances the manifestation of corneal lesions.
- Amitriptyline + Divalproex Sodium— Dosage adjustment of amitriptyline may be necessary when used concomitantly with divalproex sodium delayed-release table…
- Amitriptyline + Dopamine Hydrochloride— Concomitant use may potentiate the cardiovascular effects of dopamine, including hypertension.
- Amitriptyline + Fluconazole— Fluconazole increases the effect of amitriptyline. Dosage adjustment may be necessary; monitor plasma levels.
- Amitriptyline + Iobenguane I-123— Antidepressant that inhibits norepinephrine transporter function, potentially decreasing iobenguane uptake and causing f…
- Amitriptyline + Nabilone— Additive tachycardia, hypertension, and drowsiness reported with concurrent use.
- Amitriptyline + Nitroglycerin— Tricyclic antidepressant may cause dry mouth and diminished salivary secretions, making sublingual nitroglycerin dissolu…
- Amitriptyline + Paroxetine— Paroxetine is a strong CYP2D6 inhibitor that may increase amitriptyline concentrations. Use caution and monitor.
- Amitriptyline + Sertraline Hydrochloride— Tricyclic antidepressant that increases risk of serotonin syndrome. Monitor for signs and symptoms during treatment init…
- Amitriptyline + Valproate Sodium— Dosage adjustment of amitriptyline may be necessary if used concomitantly with valproate due to altered pharmacokinetics…
- Amitriptyline + Valproic Acid— Dosage adjustment may be necessary if used concomitantly with valproic acid.
Minor (2)
- Amitriptyline + Buspirone— Addition of buspirone to amitriptyline showed no statistically significant differences in steady-state pharmacokinetic p…
- Amitriptyline + Risperidone— Minor effect on risperidone exposure. Dose adjustment not needed.