Tricyclic antidepressant (TCA)
Amitriptyline with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Amitriptyline (Amitriptyline). Most antibiotics do not interfere meaningfully with Amitriptyline at 10mg, 25mg, 50mg, 75mg, 100mg, but a few classes do, and a small number of combinations are best avoided.
Common antibiotic interactions
Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Tricyclic antidepressant (TCA) agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Amitriptyline at 10mg, 25mg, 50mg, 75mg, 100mg.
Practical guidance
According to the prescribing information for Amitriptyline, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Amitriptyline is co-administered. Adjusted 10mg, 25mg, 50mg, 75mg, 100mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Amitriptyline during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Amitriptyline is metabolised and may need a temporary 10mg, 25mg, 50mg, 75mg, 100mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Amitriptyline regimen.
Will antibiotics make Amitriptyline stop working? ▾
Most antibiotics do not affect Amitriptyline efficacy. Rifampicin and a few others can lower Amitriptyline levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
Products containing Amitriptyline
More on Amitriptyline
- With alcoholAmitriptyline and alcohol — is it safe to drink?
- With foodShould Amitriptyline be taken with food?
- Side effectsAmitriptyline side effects: common, rare and warning signs
- Dosage guideAmitriptyline dosage guide: how much to take and when
- OnsetHow fast does Amitriptyline start working?
- DurationHow long does Amitriptyline last?
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