Delamanid 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
Delamanid
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 delamanid can each stretch out a part of your heartbeat called the QT interval. When you take them together, that effect can add up, which can raise the risk of an unusual heartbeat.
This concern is based mostly on how these drugs are expected to behave, not on lots of real-world cases, so try not to worry. Your care team can manage this. Often they will check a heart tracing (an ECG) before starting and keep an eye on it while you are on treatment. Please don't stop either medicine on your own, just talk with your pharmacist or doctor.
Additive QT-interval prolongation. Both amitriptyline (a TCA with known QT effects) and delamanid independently prolong the QT interval; concurrent use is pharmacodynamically additive, raising torsades de pointes risk. This is a PD interaction, not a metabolic one, and neither agent is activated as a prodrug here.
- Direction: increased combined QT prolongation
- Severity: major; evidence: theoretical; onset: unspecified
- Management: initiating delamanid is not recommended in patients on other QT-prolonging agents. If unavoidable, obtain baseline ECG and monitor frequently (more than monthly) throughout delamanid therapy. Correct electrolytes (K+, Mg2+) and review other QT-prolonging drugs.
What happens
Increased risk of QT-interval prolongation
Interaction Deep Dive
Delamanid belongs to the class of agents that prolong the QT interval. Because combining it with other QT-interval-prolonging medications raises the likelihood of an additive prolongation effect, starting delamanid is not advised in patients already receiving such drugs. When their combined use is unavoidable, a baseline ECG should be performed, along with repeated ECG monitoring (for example, at least monthly) throughout the entire duration of delamanid treatment1.
Why it happens (mechanism)
Additive QT- interval prolongation
How to manage this interaction
The good news is your care team has clear ways to handle this.
- Starting delamanid is generally not advised while you are on another QT-prolonging medicine like amitriptyline, so your team may consider whether an alternative is a better fit for you.
- If both are truly needed, expect a heart tracing (ECG) before you start and repeated checks (often more than once a month) during the full delamanid course.
- Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise.
- Tell your pharmacist or doctor about any fainting, dizziness, palpitations, or a racing or irregular heartbeat right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Delamanid and Amitriptyline together?
Amitriptyline and delamanid can each prolong the QT interval, and together the effect adds up, so this combination is usually avoided; if both are needed your team will use baseline and frequent ECGs to keep you safe. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Delamanid 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 Delamanid and Amitriptyline interaction managed?
The good news is your care team has clear ways to handle this. Starting delamanid is generally not advised while you are on another QT-prolonging medicine like amitriptyline, so your team may consider whether an alternative is a better fit for you. If both are truly needed, expect a heart tracing (ECG) before you start and repeated checks (often more than once a month) during the full delamanid co… 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 Delamanid 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: DELTYBA oral film-coated tablets, delamanid oral film-coated tablets. Otsuka Novel Products GmbH (per EMA), Munchen, Germany, 2014.
Keep reading about Amitriptyline
Keep reading about Delamanid
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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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