Amitriptyline and Furazolidone: 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
Furazolidone
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.
These two medicines should not be taken together. Amitriptyline (Elavil) is an antidepressant that raises certain brain chemicals like serotonin and norepinephrine. Furazolidone is an antibiotic that also acts like an MAOI, which slows the breakdown of those same chemicals. Taken together, these chemicals can build up too high.
That can cause a dangerous reaction with symptoms like high blood pressure, fever, muscle twitching, confusion, agitation, or seizures. This is considered a contraindicated combination. If you have been prescribed both, or are switching between them, please talk with your doctor or pharmacist right away so they can plan a safe path for you.
Contraindicated combination. Furazolidone possesses MAO-inhibiting activity. Combined with amitriptyline (a TCA that blocks reuptake of serotonin and norepinephrine), the result is excessive synaptic monoamine accumulation.
- Effect: risk of serotonin syndrome, hypertensive crisis, hyperthermia, myoclonus, altered mental status, seizures, neurotoxicity.
- Mechanism: altered catecholamine uptake and metabolism (reuptake inhibition plus MAO inhibition).
- Onset: delayed. Evidence: probable (case report of toxic psychosis).
- Management: avoid concurrent use. Allow >=14 days after stopping the MAOI-type agent before starting amitriptyline; initiate at low dose and titrate gradually.
What happens
Neurotoxicity, seizures, or serotonin syndrome (hypertension, hyperthermia, myoclonus, mental status changes)
Interaction Deep Dive
Toxic psychosis has been described in one case report, developing soon after furazolidone was started in a patient who was concurrently receiving amitriptyline along with other drugs1. Giving amitriptyline together with a MAOI is contraindicated2.
Why it happens (mechanism)
Altered catecholamine uptake and metabolism
How to manage this interaction
The key point: these are not meant to be used at the same time. This combination is contraindicated, so your care team will typically avoid using them together and choose an alternative.
- Keep taking exactly what your prescriber has ordered, and do not start or stop either drug on your own.
- If you are switching from furazolidone (which acts like an MAOI) to amitriptyline, expect your team to allow at least 14 days between the two.
- When amitriptyline is started, your team may begin at a low dose and adjust slowly.
- Tell your pharmacist or doctor promptly about fever, confusion, agitation, muscle twitching, or a racing/high blood pressure.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Amitriptyline and Furazolidone together?
Amitriptyline and furazolidone should not be used together because furazolidone acts as an MAOI and the pair can cause serotonin syndrome, hypertensive crisis, or seizures; allow at least 14 days between them and contact your prescriber for a safe plan. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amitriptyline and Furazolidone interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How is the Amitriptyline and Furazolidone interaction managed?
The key point: these are not meant to be used at the same time. This combination is contraindicated, so your care team will typically avoid using them together and choose an alternative. Keep taking exactly what your prescriber has ordered, and do not start or stop either drug on your own. If you are switching from furazolidone (which acts like an MAOI) to amitriptyline, expect your team to allow… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
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 Furazolidone 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 (2)
Keep reading about Amitriptyline
Keep reading about Furazolidone
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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