Clothiapine and Amitriptyline: 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
Clothiapine
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) and clothiapine can each stretch out a part of your heartbeat called the QT interval. When you take them together, those effects can add up, which can raise the chance of an irregular heartbeat.
I want to be clear that this concern is theoretical, meaning it is based on how these drugs work rather than lots of reported cases. Please don't stop either one on your own. Let your pharmacist or doctor know you take both so they can watch your heart and keep you safe. If you ever feel a fast, pounding, or fluttering heartbeat, or you get dizzy or faint, get medical help right away.
Effect: Additive QTc prolongation, increasing the theoretical risk of ventricular arrhythmias (including torsades de pointes) when amitriptyline is combined with clothiapine.
Mechanism: Both agents delay cardiac repolarization; effects are pharmacodynamically additive. Neither is a prodrug relevant to this interaction.
- Direction: Increased combined QT-prolonging effect.
- Onset: Unspecified.
- Evidence: Theoretical.
- Management: Use cautiously together. Obtain baseline and follow-up ECGs, correct electrolytes (K+, Mg2+), review other QT-prolonging agents, and use the lowest effective doses. Individualize therapy and monitor more closely.
What happens
Increased risk of cardiac arrhythmias
Interaction Deep Dive
Exercise caution when combining clothiapine with any agent recognized for prolonging the QTc interval. When such QT-prolonging drugs are taken together with clothiapine, their effects on the QTc interval may be additive, thereby heightening the likelihood of cardiac arrhythmias1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
This can usually be managed with caution and monitoring. Keep taking both medicines exactly as prescribed unless your care team tells you otherwise.
- Your team may check your heart rhythm with an ECG and review your other medicines for any that also affect the heart.
- They may keep electrolytes like potassium and magnesium in a healthy range.
- Doses may need to be adjusted and individualized by your care team.
Tell your pharmacist or prescriber that you take both drugs, and report any fainting, dizziness, or a racing or irregular heartbeat right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Clothiapine and Amitriptyline together?
Taking amitriptyline and clothiapine together may add up their effects on your heart's rhythm, so your care team should monitor you (often with an ECG) and tailor your doses. Don't stop either medicine on your own, and report any fainting or irregular heartbeat. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clothiapine and Amitriptyline 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 Clothiapine and Amitriptyline interaction managed?
This can usually be managed with caution and monitoring. Keep taking both medicines exactly as prescribed unless your care team tells you otherwise. Your team may check your heart rhythm with an ECG and review your other medicines for any that also affect the heart. They may keep electrolytes like potassium and magnesium in a healthy range. Doses may need to be adjusted and individualized by your… 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 Clothiapine or Amitriptyline 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: ENTUMIN(R) oral tablets, clotiapine oral tablets. Taro International Ltd (per Ministry of Health), Haifa Bay, Israel, 2020.
Keep reading about Amitriptyline
Keep reading about Clothiapine
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist