Amitriptyline and Voclosporin: 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
Voclosporin
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 amitriptyline and voclosporin can affect the timing of your heartbeat, something doctors call the QT interval. When two medicines that do this are taken together, the effect can add up and, in rare cases, lead to a dangerous irregular heartbeat.
The good news is that this is a known concern your care team can plan for. They may check an EKG (a heart tracing) and your blood mineral levels, especially if you already have heart risks. Please keep taking both medicines exactly as prescribed, and talk with your pharmacist or doctor before making any changes. If you feel fainting, dizziness, or a racing or pounding heartbeat, seek help right away.
Additive QTc prolongation. Amitriptyline (a TCA with known QT-prolonging potential) combined with voclosporin, which also prolongs the QTc, raises the theoretical risk of clinically significant QT prolongation, torsade de pointes, and sudden death. This is a pharmacodynamic (additive) interaction, not a metabolic one.
- Direction: additive QT effect (increased risk)
- Severity: major; evidence: theoretical
- Onset: unspecified
Management: If concomitant use is required, consider baseline and periodic ECGs and monitor/correct electrolytes (K+, Mg2+), particularly in high-risk patients. Review other QT-prolonging agents and bradycardia. Dose should be individualized by the care team.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
When voclosporin is taken alongside other agents known to prolong the QTc interval, the result may be clinically meaningful QT prolongation, which can raise the likelihood of torsade de pointes and/or sudden death. Should co-administration be necessary, obtaining electrocardiograms and checking electrolytes should be considered for patients at high risk1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Your care team can manage this by watching your heart and adjusting your plan as needed:
- Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise.
- Your team may order an EKG and check blood electrolytes (like potassium and magnesium), especially if you have other heart risk factors.
- Doses may need to be adjusted and individualized by your care team.
- Tell your pharmacist or doctor about all other medicines you take, since several can add to this effect.
Get urgent care for fainting, severe dizziness, or a fast or irregular heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Amitriptyline and Voclosporin together?
Taking amitriptyline with voclosporin can add up to a longer QT interval and a rare risk of dangerous heart rhythms; keep taking both as prescribed and ask your care team about EKG and electrolyte monitoring. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amitriptyline and Voclosporin 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 Voclosporin interaction managed?
Your care team can manage this by watching your heart and adjusting your plan as needed: Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise. Your team may order an EKG and check blood electrolytes (like potassium and magnesium), especially if you have other heart risk factors. Doses may need to be adjusted and individualized by your care team. Tell your pha… 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 Voclosporin 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: LUPKYNIS(TM) oral capsules, voclosporin oral capsules. Aurinia Pharma US Inc (per FDA), Rockville, MD, 2024. DailyMed
Keep reading about Amitriptyline
Keep reading about Voclosporin
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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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