Drug interactions
Amiodarone + Amitriptyline
Severity: Major
Amiodarone and Amitriptyline: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Amiodarone and amitriptyline both prolong the QT interval and slow conduction, raising the risk of torsades de pointes. Amiodarone may also inhibit CYP2D6 and raise tricyclic concentrations.
What this interaction means in plain words
Amiodarone and Amitriptyline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Amitriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation, plus possible CYP2D6 and CYP2C19 inhibition by amiodarone raising amitriptyline levels.
What to do
Avoid if possible and use a non-QT-prolonging antidepressant such as sertraline. If combined, monitor ECG and tricyclic effects and use the lowest effective dose.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Frequently asked questions
Can I take Amiodarone with Amitriptyline?
MediHelp rates the interaction as major. Amiodarone and Amitriptyline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Amiodarone and amitriptyline both prolong the QT interval and slow conduction, raising the risk of torsades de pointes. Amiodarone may also inhibit CYP2D6 and raise tricyclic concentrations.
How serious is the interaction between Amiodarone and Amitriptyline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible and use a non-QT-prolonging antidepressant such as sertraline. If combined, monitor ECG and tricyclic effects and use the lowest effective dose.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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