Amitriptyline and Aripiprazole: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Amitriptyline
Aripiprazole
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Both amitriptyline (Elavil) and aripiprazole (Abilify) can gently affect your heart's electrical rhythm, causing something called QT prolongation. When two medicines that both do this are taken together, the effect can add up and, in rare cases, lead to an abnormal heartbeat.
The good news is that this concern is mostly theoretical, meaning it's based on how the drugs work rather than a lot of real-world problems. Many people take medicines like these safely. Your care team can keep an eye on this, sometimes with a simple heart tracing (EKG). Don't stop either medicine on your own. Just talk with your doctor or pharmacist, especially if you feel dizzy, faint, or have a fluttering heartbeat.
Effect: Additive QTc interval prolongation with combined use of amitriptyline (a TCA with known QT-prolonging potential) and aripiprazole.
Mechanism: Additive pharmacodynamic effect on cardiac repolarization; both agents can prolong the QT interval. This is a PD interaction, not an enzymatic one.
Evidence: Theoretical; severity rated major.
- Assess baseline and cumulative QT risk factors (electrolytes, bradycardia, other QT agents, congenital long QT).
- Correct hypokalemia/hypomagnesemia.
- Consider baseline and follow-up ECG monitoring.
- Doses may be individualized; monitor more closely if used together.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
When ARIPiprazole or its prodrug ARIPiprazole lauroxil is taken together with other agents that prolong the QT interval, prolongation of the QTc interval may result12345.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
If your care team has prescribed both, they have likely weighed the benefits against this risk. Here is what typically helps:
- Keep taking both as prescribed unless your doctor tells you otherwise.
- Your team may check an EKG and blood tests (like potassium and magnesium) before or during treatment.
- Doses may be adjusted and individualized by your care team, and they may monitor you more closely when the two are combined.
Call your prescriber or pharmacist if you notice fainting, dizziness, palpitations, or a pounding or irregular heartbeat. Mention any other QT-affecting medicines you take.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Amitriptyline and Aripiprazole together?
Taking amitriptyline and aripiprazole together can add up to slightly raise the risk of a heart rhythm change (QT prolongation), so keep taking both as prescribed and let your care team monitor you and adjust doses as needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amitriptyline and Aripiprazole interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Amitriptyline and Aripiprazole interaction managed?
If your care team has prescribed both, they have likely weighed the benefits against this risk. Here is what typically helps: Keep taking both as prescribed unless your doctor tells you otherwise. Your team may check an EKG and blood tests (like potassium and magnesium) before or during treatment. Doses may be adjusted and individualized by your care team, and they may monitor you more closely whe… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Amitriptyline or Aripiprazole need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (5)
- Product Information: ABILIFY(R) oral tablets, oral solution, intramuscular injection, aripiprazole oral tablets, oral solution, intramuscular injection. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2022. DailyMed
- Product Information: ABILIFY MAINTENA(R) intramuscular extended-release injection, aripiprazole intramuscular extended-release injection. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2020.
- Product Information: ABILIFY ASIMTUFII(R) intramuscular extended-release suspension, aripiprazole intramuscular extended-release suspension. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2023.
- Product Information: ARISTADA(R) intramuscular extended-release injection, aripiprazole lauroxil intramuscular extended-release injection. Alkermes Inc (per FDA), Waltham, MA, 2018.
- Product Information: ARISTADA INITIO (R) intramuscular extended-release injection, aripiprazole lauroxil intramuscular extended-release injection. Alkermes, Inc (per manufacturer), Waltham, MA, 2020.
Keep reading about Amitriptyline
Keep reading about Aripiprazole
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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