Drug interactions
Amitriptyline + Trazodone
Severity: Major
Amitriptyline and Trazodone: 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
Both drugs have serotonergic activity and can prolong the QT interval, and trazodone may raise tricyclic concentrations. Together they raise the risk of serotonin syndrome, arrhythmia, sedation and hypotension.
What this interaction means in plain words
Amitriptyline and Trazodone 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.
Amitriptyline belongs to Central Nervous System; Trazodone belongs to Central Nervous System.
Why it happens
Additive serotonergic effects and QT prolongation, with possible pharmacokinetic increase in tricyclic levels.
What to do
Avoid combining where possible. If used, keep doses low, monitor ECG and watch for serotonin toxicity, orthostasis and oversedation.
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 Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Other interactions of Trazodone
- Arsenic trioxide + Trazodone Contraindicated
- Ibutilide + Trazodone Contraindicated
- Isocarboxazid + Trazodone Contraindicated
- Levoketoconazole + Trazodone Contraindicated
- Methylene blue + Trazodone Contraindicated
- Phenelzine + Trazodone Contraindicated
Frequently asked questions
Can I take Amitriptyline with Trazodone?
MediHelp rates the interaction as major. Amitriptyline and Trazodone 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. Both drugs have serotonergic activity and can prolong the QT interval, and trazodone may raise tricyclic concentrations. Together they raise the risk of serotonin syndrome, arrhythmia, sedation and hypotension.
How serious is the interaction between Amitriptyline and Trazodone?
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 combining where possible. If used, keep doses low, monitor ECG and watch for serotonin toxicity, orthostasis and oversedation.
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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