Amitriptyline and Tedizolid Phosphate: 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
Tedizolid Phosphate
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.
Amitriptyline (Elavil) raises serotonin, a chemical messenger in your brain. Tedizolid (Sivextro), an antibiotic, can also nudge serotonin levels up. Taking both together can mean too much serotonin, which in rare cases leads to a reaction called serotonin syndrome.
Warning signs include feeling agitated or restless, sweating, shaking or twitching muscles, a fast heartbeat, or a fever. This is uncommon, and tedizolid is usually only taken for a short time. The good news is your care team can manage this safely by watching for these symptoms. If you feel any of them, contact your doctor or pharmacist right away.
Effect: Additive serotonergic activity increasing the risk of serotonin syndrome. Amitriptyline blocks serotonin reuptake; tedizolid (an oxazolidinone) has weak reversible MAO inhibition. Neither is a prodrug here; this is a pharmacodynamic, not pharmacokinetic, interaction.
- Direction: Additive CNS serotonergic tone.
- Severity: Major. Evidence: Theoretical (post-marketing case reports).
- Onset: Unspecified; can occur early.
- Monitor: Hyperthermia, diaphoresis, agitation, hyperreflexia, clonus, tremor, muscle rigidity, autonomic instability.
- Management: If symptoms emerge, consider discontinuing tedizolid and/or the serotonergic agent and initiate supportive care.
What happens
An increased risk of serotonin syndrome
Interaction Deep Dive
Serotonin syndrome has been documented in patients receiving tedizolid together with serotonergic drugs during post marketing surveillance. For this reason, when these agents are given concurrently, watch patients for signs that serotonin syndrome may be developing. Should signs or symptoms of serotonin syndrome appear, it may be appropriate to stop tedizolid and/or the accompanying serotonergic drugs as clinically warranted, along with starting supportive care. Patients should be advised that combining tedizolid with serotonergic agents raises their risk of serotonin syndrome. The manifestations linked to serotonin syndrome can include hyperthermia, diaphoresis, agitation, hyperreflexia, clonus, pyrexia, opsoclonus, muscle rigidity, tremor, and hypertonia1.
Why it happens (mechanism)
Additive serotonergic effects
How to manage this interaction
If your prescriber has you on both, keep taking them as directed unless told otherwise. Tedizolid is typically a short course, which helps limit the risk.
- Your care team may monitor you more closely while you take both together.
- Watch for warning signs: high fever, heavy sweating, agitation, muscle twitching or stiffness, tremor, or a racing heart.
- If any of these appear, contact your doctor or pharmacist right away, since they may adjust or stop one of the medicines and provide supportive care.
- Ask your pharmacist before adding any new serotonin-affecting medicines.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) During post marketing surveillance, cases of serotonin syndrome have been documented in patients receiving tedizolid together with serotonergic agents 1.
Common questions
Can I take Amitriptyline and Tedizolid Phosphate together?
Combining amitriptyline and tedizolid can add up to too much serotonin, so watch for symptoms like fever, sweating, agitation, or muscle twitching and report them promptly. Keep taking both as prescribed and let your care team monitor you. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amitriptyline and Tedizolid Phosphate 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 Tedizolid Phosphate interaction managed?
If your prescriber has you on both, keep taking them as directed unless told otherwise. Tedizolid is typically a short course, which helps limit the risk. Your care team may monitor you more closely while you take both together. Watch for warning signs: high fever, heavy sweating, agitation, muscle twitching or stiffness, tremor, or a racing heart. If any of these appear, contact your doctor or ph… 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 Tedizolid Phosphate 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)
- Product Information: SIVEXTRO® intravenous injection, oral tablets, tedizolid phosphate intravenous injection, oral tablets. Merck Sharp & Dohme Corp (per FDA), Rahway, NJ, 2026. DailyMed
Keep reading about Amitriptyline
Keep reading about Tedizolid Phosphate
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