Amitriptyline Interactions

492 known interactions for Amitriptyline. Click any interaction for the full evidence-based breakdown.

⚠️ Major (9)

Amitriptyline + 5-HTPDANGEROUS — do not combine serotonin precursors with serotonergic drugs
Amitriptyline + AlcoholDANGEROUS — additive CNS depression + increased TCA toxicity
Amitriptyline + FluoxetineDANGEROUS — fluoxetine is the worst SSRI to combine with TCAs due to potent CYP2D6 inhibition
Amitriptyline + HydrocodoneDANGEROUS — additive CNS/respiratory depression
Amitriptyline + OxycodoneDANGEROUS — additive respiratory depression
Amitriptyline + ParoxetineDANGEROUS — potent CYP2D6 inhibition elevates TCA levels
Amitriptyline + SertralineDANGEROUS — TCA levels increase dramatically + serotonin syndrome risk
Amitriptyline + St. Johns WortDANGEROUS — serotonin syndrome risk + reduced TCA efficacy
Amitriptyline + TramadolDANGEROUS — dual serotonergic mechanism + seizure risk

⚡ Moderate (1)

Amitriptyline + AlprazolamCAUTION — additive sedation; commonly co-prescribed but monitor

✅ Safe (482)