Amitriptyline and Domperidone: 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
Domperidone
No brand names on record
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 of these medicines can affect the electrical rhythm of your heart in a similar way. Amitriptyline (Elavil), an older antidepressant, and domperidone, which helps with stomach and nausea problems, can each stretch out part of the heartbeat called the QT interval. Taken together, that effect can add up and, in rare cases, lead to a dangerous heart rhythm.
This is a caution based mostly on how these drugs work, not proof it happens often. The risk is higher with higher domperidone doses and in people over 60. Please don't change anything on your own. Tell your pharmacist or doctor you take both so they can keep you safe, and call them right away if you feel dizzy, have a fluttering heartbeat, or faint.
Effect: Additive QT prolongation with coadministration of amitriptyline and domperidone, raising the risk of ventricular arrhythmias (including torsades de pointes) and sudden cardiac death.
- Mechanism: Additive pharmacodynamic effect on cardiac repolarization; both agents prolong the QT interval. Neither is a prodrug relevant to this effect.
- Evidence: Theoretical for the combination; case-control data link oral domperidone to increased sudden cardiac death, especially at >30 mg/day and age >60.
- Onset: Unspecified.
- Management: Use with caution. Initiate domperidone at the lowest dose, titrate carefully, consider baseline/periodic ECG and electrolyte monitoring. Discontinue domperidone if dizziness, palpitations, syncope, or seizure occur.
What happens
Increased risk of QT interval prolongation
Interaction Deep Dive
Exercise caution when amitriptyline, which may prolong the QT interval, is given together with domperidone, an agent linked to a heightened risk of sudden cardiac death. Case control studies found that oral domperidone raised the risk of sudden cardiac death, especially at doses exceeding 30 mg/day and among patients over 60 years old. When the two must be used concurrently, domperidone should be started at the lowest feasible dose and titrated cautiously. Should the patient develop dizziness, palpitations, syncope, or seizure, domperidone should be stopped1.
Why it happens (mechanism)
Additive effects on the QT interval
How to manage this interaction
Your care team can manage this combination safely with a few precautions.
- Keep taking both as prescribed unless your prescriber tells you otherwise.
- If domperidone is needed, it is usually started at the lowest possible dose and increased slowly. Dosing may be adjusted and individualized by your care team.
- Your team may monitor you more closely, especially if you are over 60 or on higher domperidone doses.
- Call your doctor or pharmacist right away if you notice dizziness, a racing or fluttering heartbeat, fainting, or a seizure.
- Tell every provider about both medicines and any heart or electrolyte problems.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Amitriptyline and Domperidone together?
Amitriptyline and domperidone can each prolong the QT interval, so together they may raise the risk of a serious heart rhythm problem, especially at higher domperidone doses or over age 60. Keep taking both as prescribed, use the lowest effective domperidone dose, and get urgent help for dizziness, palpitations, or fainting. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amitriptyline and Domperidone 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 Domperidone interaction managed?
Your care team can manage this combination safely with a few precautions. Keep taking both as prescribed unless your prescriber tells you otherwise. If domperidone is needed, it is usually started at the lowest possible dose and increased slowly. Dosing may be adjusted and individualized by your care team. Your team may monitor you more closely, especially if you are over 60 or on higher domperido… 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 Domperidone 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 (1)
- Teva Canada Limited: Dear Healthcare Professional letter for domperidone maleate. Teva Canada Limited. Toronto, Canada. 2012.
Keep reading about Amitriptyline
Keep reading about Domperidone
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist