Drug interactions
Amitriptyline + Esomeprazole
Severity: Moderate
Amitriptyline and Esomeprazole: 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
Esomeprazole inhibits CYP2C19, which demethylates amitriptyline, and may raise amitriptyline levels. This could increase anticholinergic, sedative and cardiac effects.
What this interaction means in plain words
Amitriptyline and Esomeprazole 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; Esomeprazole belongs to Gastrointestinal Tract.
Why it happens
Esomeprazole inhibits CYP2C19-mediated metabolism of amitriptyline.
What to do
Monitor for tricyclic adverse effects and consider ECG or plasma level monitoring. Lower the amitriptyline dose if toxicity develops.
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 Esomeprazole
- Esomeprazole + Mavacamten Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Esomeprazole Major
- Atazanavir + Esomeprazole Major
- Citalopram + Esomeprazole Major
- Clopidogrel + Esomeprazole Major
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 Amitriptyline with Esomeprazole?
MediHelp rates the interaction as moderate. Amitriptyline and Esomeprazole 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. Esomeprazole inhibits CYP2C19, which demethylates amitriptyline, and may raise amitriptyline levels. This could increase anticholinergic, sedative and cardiac effects.
How serious is the interaction between Amitriptyline and Esomeprazole?
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 for tricyclic adverse effects and consider ECG or plasma level monitoring. Lower the amitriptyline dose if toxicity develops.
What other medicines interact with Esomeprazole?
MediHelp also lists interactions of Esomeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Esomeprazole page.
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