Drug interactions
Amitriptyline + Ranolazine
Severity: Moderate
Amitriptyline and Ranolazine: 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
Ranolazine inhibits P-glycoprotein and CYP2D6 and may modestly raise amitriptyline exposure. Both drugs can prolong the QT interval, so the combination adds to arrhythmia risk and anticholinergic or sedative effects.
What this interaction means in plain words
Amitriptyline and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
Weak P-gp and CYP2D6 inhibition by ranolazine raising tricyclic levels, plus additive QT prolongation.
What to do
Monitor ECG and tricyclic adverse effects, and use the lowest effective amitriptyline dose. Consider an alternative antidepressant in patients with other QT risk factors.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine 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 Amitriptyline with Ranolazine?
MediHelp rates the interaction as moderate. Amitriptyline and Ranolazine 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. Ranolazine inhibits P-glycoprotein and CYP2D6 and may modestly raise amitriptyline exposure. Both drugs can prolong the QT interval, so the combination adds to arrhythmia risk and anticholinergic or sedative effects.
How serious is the interaction between Amitriptyline and Ranolazine?
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 ECG and tricyclic adverse effects, and use the lowest effective amitriptyline dose. Consider an alternative antidepressant in patients with other QT risk factors.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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