Drug interactions
Amitriptyline + Atomoxetine
Severity: Moderate
Amitriptyline and Atomoxetine: moderate 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
Both drugs can affect cardiac conduction and repolarisation, and atomoxetine also raises heart rate and blood pressure. Atomoxetine is a CYP2D6 substrate and amitriptyline may weakly inhibit this pathway, while both have noradrenergic effects.
What this interaction means in plain words
Amitriptyline and Atomoxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Atomoxetine belongs to Central Nervous System.
Why it happens
Additive effects on QT and cardiovascular function through noradrenergic reuptake inhibition, with possible CYP2D6 competition.
What to do
Monitor heart rate, blood pressure and ECG, particularly in patients with cardiac disease. Use the lowest effective doses.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Other interactions of Atomoxetine
- Atomoxetine + Isocarboxazid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Atomoxetine + Rasagiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Amitriptyline with Atomoxetine?
MediHelp rates the interaction as moderate. Amitriptyline and Atomoxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs can affect cardiac conduction and repolarisation, and atomoxetine also raises heart rate and blood pressure. Atomoxetine is a CYP2D6 substrate and amitriptyline may weakly inhibit this pathway, while both have noradrenergic effects.
How serious is the interaction between Amitriptyline and Atomoxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate, blood pressure and ECG, particularly in patients with cardiac disease. Use the lowest effective doses.
What other medicines interact with Amitriptyline?
MediHelp also lists interactions of Amitriptyline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Amitriptyline page.
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