Amitriptyline and Lumiracoxib: 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
Lumiracoxib
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.
You've been prescribed amitriptyline (a tricyclic antidepressant) along with lumiracoxib (an anti-inflammatory pain reliever, a type of NSAID). Taking these two together can raise your risk of bleeding. This can include bleeding in the stomach or, more rarely, bleeding in the brain, especially in the first month of using them together.
The good news is this is very manageable. Keep taking both exactly as prescribed, and let your care team know. Watch for warning signs like unusual bruising, black or bloody stools, vomit that looks like coffee grounds, or a bad headache that won't go away, and reach out right away if any of these happen.
Effect: Increased bleeding risk (including intracranial hemorrhage) with concomitant NSAID (lumiracoxib) and tricyclic antidepressant (amitriptyline).
- Direction: Additive/pharmacodynamic bleeding risk; effect is increased.
- Mechanism: Unknown/unspecified. TCAs may impair platelet function; NSAIDs contribute GI mucosal injury and antiplatelet effects.
- Onset: Unspecified; excess intracranial hemorrhage reported within 30 days of concomitant use.
- Evidence: Established. Severity major.
- Management: Monitor for signs of bleeding (GI blood loss, bruising, neurologic changes). Consider gastroprotection and individualized regimen review by the care team.
What happens
An increased risk of bleeding
Interaction Deep Dive
Exercise caution if NSAIDs are given together with tricyclic antidepressants, because this combination can raise the risk of bleeding, such as intracranial hemorrhage, occurring within 30 days of using them together1. For patients receiving both an NSAID and a tricyclic antidepressant at the same time, watch for indications of heightened bleeding.
Why it happens (mechanism)
Unknown
How to manage this interaction
This combination is used sometimes, but your care team will watch it closely.
- Keep taking both as prescribed unless your prescriber tells you otherwise.
- Your team may monitor you more closely for signs of bleeding, and your regimen may be adjusted and individualized to lower your risk.
- Watch for and promptly report: black, tarry, or bloody stools, coffee-ground vomit, unusual bruising, nosebleeds that won't stop, or a sudden severe headache.
Ask your pharmacist or prescriber whether a stomach-protecting medicine is appropriate and whether either drug could be swapped for a safer option.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) Combined administration of NSAIDs and antidepressants, including tricyclic antidepressants, SSRIs, serotonin-norepinephrine reuptake inhibitors, and MAOIs, was associated with a heightened risk of intracranial hemorrhage within 30 days of concurrent use when compared with antidepressant use by itself. No meaningful difference in the elevated risk was observed among the antidepressant drug classes; however, an increased risk was seen in male patients relative to female patients 1.
Common questions
Can I take Amitriptyline and Lumiracoxib together?
Combining amitriptyline with the NSAID lumiracoxib raises bleeding risk, so keep taking both as prescribed but watch for signs of bleeding and report them to your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amitriptyline and Lumiracoxib 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 Lumiracoxib interaction managed?
This combination is used sometimes, but your care team will watch it closely. Keep taking both as prescribed unless your prescriber tells you otherwise. Your team may monitor you more closely for signs of bleeding, and your regimen may be adjusted and individualized to lower your risk. Watch for and promptly report: black, tarry, or bloody stools, coffee-ground vomit, unusual bruising, nosebleeds… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
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 Lumiracoxib 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)
- Shin JY, Park MJ, Lee SH, et al: Risk of intracranial haemorrhage in antidepressant users with concurrent use of non-steroidal anti-inflammatory drugs: nationwide propensity score matched study. BMJ 2015; 351:h3517. PubMed
Keep reading about Amitriptyline
Keep reading about Lumiracoxib
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