Amitriptyline and Sultopride: 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
Sultopride
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 your heart's rhythm. Amitriptyline (Elavil) is a tricyclic antidepressant, and sultopride is an antipsychotic. Each one on its own can slightly stretch out the electrical timing in your heart (called the QT interval). When you take them together, those effects can add up. In rare cases, a very stretched QT interval can trigger a dangerous, fast heartbeat.
This concern is based on how the drugs work rather than on studies of the two together, but it is taken seriously. Please don't stop either medicine on your own. Talk with your doctor or pharmacist, they can review your heart health and choose the safest plan for you.
Additive QT prolongation risk. Amitriptyline (TCA) and sultopride (benzamide antipsychotic) each independently prolong the QT interval. Coadministration produces additive cardiac electrophysiologic effects, increasing risk of QT prolongation, torsades de pointes, and cardiac arrest.
- Direction: additive pharmacodynamic effect (not a metabolic/prodrug interaction).
- Evidence: theoretical; no formal interaction studies.
- Onset: unspecified.
- Management: concurrent use of a TCA with an antipsychotic is not recommended. If unavoidable, individualize dosing, correct electrolytes (K+, Mg2+), obtain baseline and follow-up ECGs, and review other QT-prolonging agents.
What happens
An increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)
Interaction Deep Dive
QT-interval prolongation has been linked to a number of antipsychotic medications23456. While formal studies examining this drug interaction have not been conducted, giving a tricyclic antidepressant together with an antipsychotic is not advised7.
Why it happens (mechanism)
Additive cardiac effects
How to manage this interaction
The main step here is a conversation with your care team. Because both drugs can affect heart rhythm, guidance is that a tricyclic antidepressant and an antipsychotic generally should not be used together.
- Keep taking both exactly as prescribed until your prescriber advises otherwise, do not stop on your own.
- Your team may check an ECG and your electrolytes, and may consider an alternative medicine or adjust and individualize your doses.
- Tell your prescriber if you take other medicines that affect heart rhythm.
- Get urgent help for fainting, palpitations, dizziness, or a racing/irregular heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) During clinical trials with pimozide, electrocardiographic alterations that were observed included lengthening of the corrected QT interval, as well as flattening, notching, and inversion of the T wave and the emergence of U waves. In experimental research, sudden and unexpected deaths occurred in patients receiving pimozide at doses of 1 mg/kg. The suggested mechanism underlying these deaths is prolongation of the QT interval, which predisposes patients to ventricular arrhythmias 1.
Common questions
Can I take Amitriptyline and Sultopride together?
Combining amitriptyline and sultopride can add together their effects on heart rhythm and is generally not recommended, so ask your doctor or pharmacist to review this pairing before continuing. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amitriptyline and Sultopride 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 Sultopride interaction managed?
The main step here is a conversation with your care team. Because both drugs can affect heart rhythm, guidance is that a tricyclic antidepressant and an antipsychotic generally should not be used together. Keep taking both exactly as prescribed until your prescriber advises otherwise, do not stop on your own. Your team may check an ECG and your electrolytes, and may consider an alternative medicin… 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 Sultopride 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 (7)
- Product Information: Orap(R), pimozide. Gate Pharmaceuticals, Sellersville, PA, 1999. DailyMed
- O'Brien JM, Rockwood RP, & Suh KI: Haloperidol-induced torsade de pointes. Ann Pharmacother 1999; 33(10):1046-1050. PubMed
- Duenas-Laita A, Castro-Villamor MA, Martin-Escudero JC, et al: New clinical manifestations of acute risperidone poisoning (letter). Clin Toxicol 1999; 37(7):893-894. PubMed
- Agelink MW, Zeit T, Baumann B, et al: In vivo cardiovascular effects of the new atypical neuroleptic sertindole. Int J Psychiatry Clin Pract 2001; 5:33-40. PubMed
- Lande G, Drouin E, Gauthier C, et al: Arrhythmogenic effects of sultopride chlorhydrate: clinical and cellular electrophysiological correlation. Ann Fr Anesth Reanim 1992; 11:629-635.
- Sweetman S (Ed): Martindale: The Complete Drug Reference. London: Pharmaceutical Press. Electronic version, MICROMEDEX, Greenwood Village, Colorado, Edition expires 06/2003.
- Product Information: Pamelor(R), nortriptyline. Mallinkroft Inc. St. Louis, MO, 2001. DailyMed
Keep reading about Amitriptyline
Keep reading about Sultopride
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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