Drug interactions
Amitriptyline + Grapefruit
Severity: Minor
Amitriptyline and Grapefruit: minor 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
Grapefruit juice can inhibit intestinal CYP3A4 and may modestly raise amitriptyline exposure. The clinical effect is usually small, because amitriptyline is cleared mainly by CYP2C19 and CYP2D6.
What this interaction means in plain words
Amitriptyline and Grapefruit have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
Inhibition of intestinal CYP3A4 metabolism, which may modestly increase amitriptyline bioavailability.
What to do
No routine change is needed. Advise patients with signs of tricyclic toxicity such as sedation, dry mouth or palpitations to avoid large regular intakes of grapefruit juice.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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
Frequently asked questions
Can I take Amitriptyline with Grapefruit?
MediHelp rates the interaction as minor. Amitriptyline and Grapefruit have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Grapefruit juice can inhibit intestinal CYP3A4 and may modestly raise amitriptyline exposure. The clinical effect is usually small, because amitriptyline is cleared mainly by CYP2C19 and CYP2D6.
How serious is the interaction between Amitriptyline and Grapefruit?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine change is needed. Advise patients with signs of tricyclic toxicity such as sedation, dry mouth or palpitations to avoid large regular intakes of grapefruit juice.
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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