Droxicam 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
Droxicam
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.
You've been prescribed amitriptyline (a tricyclic antidepressant) and droxicam (an anti-inflammatory pain medicine, an NSAID). When these are taken together, they can raise your risk of bleeding. In rare cases this can include serious bleeding, such as bleeding in the brain.
The good news is that this is manageable. Watch for warning signs like unusual bruising, blood in your stool or urine, black or tarry stools, nosebleeds that won't stop, or a bad headache that isn't normal for you. Please don't stop either medicine on your own. Talk with your pharmacist or doctor so they can keep an eye on you and adjust things if needed.
Effect: Increased bleeding risk, including reports of intracranial hemorrhage within 30 days of concurrent NSAID + TCA use.
- Direction: Additive/pharmacodynamic increase in bleeding tendency (neither drug is a prodrug here).
- Mechanism: Not established. TCAs can impair platelet function via serotonin-mediated aggregation effects; NSAIDs inhibit platelet cyclooxygenase and irritate GI mucosa, giving additive bleeding risk.
- Evidence: Established. Severity: Major. Onset: Unspecified.
- Management: Use caution. Monitor for signs of bleeding (GI bleed, bruising, neurologic changes). Dose/therapy may be individualized; consider alternatives per clinical judgment.
What happens
An increased risk of bleeding
Interaction Deep Dive
Exercise caution when NSAIDs and tricyclic antidepressants are administered together, since the combination may raise the risk of bleeding, including intracranial hemorrhage occurring within 30 days of joint use1. During concurrent therapy with these two drug classes, watch the patient for indications of heightened bleeding.
Why it happens (mechanism)
Unknown
How to manage this interaction
Your care team can manage this combination safely with a few precautions:
- Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise.
- Your team may monitor you more closely for signs of bleeding, and your doses may be adjusted and individualized to your situation.
- Report right away: unusual bruising, black or tarry stools, blood in urine or vomit, prolonged nosebleeds, or a sudden severe headache.
- Ask your pharmacist before adding other pain relievers or blood thinners, since these can add to the risk.
Bring this up at your next visit so your prescriber can review whether this combination is right for you.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) The combined use of NSAIDs with antidepressants, including tricyclic antidepressants, SSRIs, serotonin-norepinephrine reuptake inhibitors, and MAOIs, was associated with a higher risk of intracranial hemorrhage within 30 days of concurrent use when compared with the use of an antidepressant alone. No significant difference in this elevated risk was found across the antidepressant drug classes; however, an increased risk was observed in male patients relative to female patients 1.
Common questions
Can I take Droxicam and Amitriptyline together?
Taking amitriptyline with droxicam can increase your bleeding risk, so keep taking both as prescribed but watch for signs of bleeding and let your pharmacist or doctor monitor you. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Droxicam 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 Droxicam and Amitriptyline interaction managed?
Your care team can manage this combination safely with a few precautions: Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise. Your team may monitor you more closely for signs of bleeding, and your doses may be adjusted and individualized to your situation. Report right away: unusual bruising, black or tarry stools, blood in urine or vomit, prolonged nosebleeds, or… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Droxicam 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)
- Shin JY, Park MJ, Lee SH, et al: Risk of intracranial haemorrhage in antidepressant users with concurrent use of non-steroidal anti-inflammatory drugs: nationwide propensity score matched study. BMJ 2015; 351:h3517. PubMed
Keep reading about Amitriptyline
Keep reading about Droxicam
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