Drug interactions
Amitriptyline + Verapamil
Severity: Moderate
Amitriptyline and Verapamil: 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
Verapamil may increase amitriptyline levels and add to its hypotensive and conduction effects. This can raise the risk of sedation, orthostatic hypotension, anticholinergic effects and arrhythmia or AV block.
What this interaction means in plain words
Amitriptyline and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits CYP enzymes and P-glycoprotein, reducing amitriptyline clearance, with additive pharmacodynamic cardiac and hypotensive effects.
What to do
Monitor ECG, blood pressure and tricyclic adverse effects, and consider lowering the amitriptyline dose. Check tricyclic levels if toxicity is suspected.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil 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 Verapamil?
MediHelp rates the interaction as moderate. Amitriptyline and Verapamil 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. Verapamil may increase amitriptyline levels and add to its hypotensive and conduction effects. This can raise the risk of sedation, orthostatic hypotension, anticholinergic effects and arrhythmia or AV block.
How serious is the interaction between Amitriptyline and Verapamil?
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, blood pressure and tricyclic adverse effects, and consider lowering the amitriptyline dose. Check tricyclic levels if toxicity is suspected.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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