Etoricoxib 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
Etoricoxib
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) along with etoricoxib (an anti-inflammatory pain reliever, an NSAID). Taken together, these two can raise your risk of bleeding. In rare cases this has included bleeding in the brain within the first month of using both.
This doesn't mean you can't take them together, but it is worth paying attention to. Watch for things like unusual bruising, blood in your stool or urine, nosebleeds that won't stop, or a bad headache that won't go away. The good news is your care team can manage this safely by keeping a closer eye on you. Talk with your pharmacist or doctor before changing anything.
Effect: Increased bleeding risk when a tricyclic antidepressant (amitriptyline) is combined with an NSAID (etoricoxib), including reports of intracranial hemorrhage within 30 days of concomitant use.
- Mechanism: Unknown; a pharmacodynamic additive effect on bleeding is plausible, but not established. Neither agent is a prodrug relevant to this interaction.
- Direction: Additive/increased bleeding risk.
- Onset: Unspecified; events reported within 30 days.
- Evidence: Established. Severity major.
- Management: Use caution with coadministration. Monitor for signs and symptoms of bleeding (GI, mucocutaneous, neurologic). Dosing may be individualized and alternatives considered by the care team.
What happens
An increased risk of bleeding
Interaction Deep Dive
Exercise caution when NSAIDs and tricyclic antidepressants are administered together, because the combination may raise the risk of bleeding, such as intracranial hemorrhage occurring within 30 days of concurrent use1. If these two agents are used at the same time, watch the patient for any indications of heightened bleeding.
Why it happens (mechanism)
Unknown
How to manage this interaction
If both medications have been prescribed, keep taking them as directed unless your prescriber tells you otherwise. Your care team can manage this combination safely.
- Your team may monitor you more closely for signs of bleeding.
- They may adjust and individualize your regimen, or consider an alternative pain reliever if appropriate.
- Watch for and promptly report: unusual bruising, black or bloody stools, blood in urine, prolonged nosebleeds, vomiting blood, or a sudden severe headache.
Raise any of these symptoms, or any concerns about combining these drugs, with your pharmacist or doctor.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) The combined use of NSAIDs and antidepressants, including tricyclic antidepressants, SSRIs, serotonin-norepinephrine reuptake inhibitors, and MAOIs, produced a heightened risk of intracranial hemorrhage within 30 days of concurrent use relative to antidepressant use by itself. No meaningful difference was observed among the antidepressant drug classes with respect to this elevated risk; however, an increased risk was found in male patients compared with female patients 1.
Common questions
Can I take Etoricoxib and Amitriptyline together?
Combining amitriptyline with the NSAID etoricoxib can increase bleeding risk, so watch for signs of bleeding and stay in touch with your care team. Do not stop or change either medication on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Etoricoxib 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 Etoricoxib and Amitriptyline interaction managed?
If both medications have been prescribed, keep taking them as directed unless your prescriber tells you otherwise. Your care team can manage this combination safely. Your team may monitor you more closely for signs of bleeding. They may adjust and individualize your regimen, or consider an alternative pain reliever if appropriate. Watch for and promptly report: unusual bruising, black or bloody st… 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 Etoricoxib 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 Etoricoxib
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