Dronedarone 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
Dronedarone
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 an older antidepressant, and dronedarone (Multaq) is a heart rhythm medicine. Each one can stretch out a part of your heartbeat called the QT interval. When you take them together, that effect adds up, and this raises the risk of a dangerous, fast heartbeat.
Because of this, the two are generally not meant to be used together. This is very manageable, though. Please don't stop either medicine on your own. Instead, talk with your doctor or pharmacist. They can look at your full list of medicines and pick a safer combination for you.
Interaction: Additive QT-interval prolongation with coadministration of amitriptyline (a tricyclic antidepressant) and dronedarone (a Class III antiarrhythmic).
- Mechanism: Additive PD effect on cardiac repolarization; dronedarone alone increases QTc by ~+10 ms at 400 mg BID.
- Direction/risk: Increased risk of torsade de pointes-type ventricular tachycardia. Neither agent is a prodrug; effect is pharmacodynamic, not clearance-based.
- Evidence: Probable. Severity: Contraindicated.
- Management: Avoid the combination. If unavoidable, individualize therapy and consider ECG/QTc and electrolyte (K+, Mg2+) monitoring per cardiology.
What happens
Increased risk of QT interval prolongation
Interaction Deep Dive
A moderate, dose-dependent influence on the QTc interval is seen with dronedarone, producing a rise of +10 milliseconds at a dose of 400 mg taken twice daily. Because of the possible risk of torsade de pointes-type ventricular tachycardia, it is contraindicated to give it together with agents that prolong the QT interval (for example, certain phenothiazines, tricyclic antidepressants, certain macrolide antibiotics, and Class I and III antiarrhythmics)1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
This combination is generally avoided because both drugs prolong the QT interval and the effect adds together.
- Keep taking both as prescribed for now and do not stop either one on your own.
- Contact your pharmacist or prescriber promptly to review this pairing. Your care team will often choose an alternative medicine rather than use these two together.
- If your team decides you must take both, they may monitor you more closely with ECGs and check your electrolytes (like potassium and magnesium).
- Get urgent help for fainting, palpitations, or a racing/irregular heartbeat.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Dronedarone and Amitriptyline together?
Amitriptyline and dronedarone both prolong the QT interval, and using them together is contraindicated because of the risk of a dangerous heart rhythm; contact your doctor or pharmacist to find a safer alternative. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Dronedarone and Amitriptyline interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Dronedarone and Amitriptyline interaction managed?
This combination is generally avoided because both drugs prolong the QT interval and the effect adds together. Keep taking both as prescribed for now and do not stop either one on your own. Contact your pharmacist or prescriber promptly to review this pairing. Your care team will often choose an alternative medicine rather than use these two together. If your team decides you must take both, they… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Dronedarone 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: MULTAQ(R) oral tablets, dronedarone oral tablets. sanofi-aventis US LLC (per manufacturer), Bridgewater, NJ, 2017. DailyMed
Keep reading about Amitriptyline
Keep reading about Dronedarone
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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