Goserelin 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
Goserelin
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're taking two medicines that can each affect your heart's rhythm. Amitriptyline (Elavil), an older antidepressant, and goserelin, a hormone therapy, can both stretch out a part of your heartbeat called the QT interval. When taken together, that effect can add up and, in some people, raise the risk of an irregular heartbeat.
The good news is this concern is mostly theoretical, and your care team can manage it well. They may keep an eye on your heart tracing (ECG) and blood minerals like potassium and magnesium. Please don't stop either medicine on your own. Just check in with your doctor or pharmacist so they can watch things closely.
Effect: Additive QT-interval prolongation with concurrent amitriptyline and goserelin.
- Mechanism: Pharmacodynamic. Amitriptyline (TCA) prolongs QT via cardiac ion-channel effects; androgen deprivation from the GnRH agonist goserelin can also prolong QT. Neither is a prodrug relevant here; the interaction is additive PD, not PK.
- Direction/magnitude: Increased torsadogenic risk; magnitude not quantified.
- Onset: Unspecified. Evidence: Theoretical.
- Management: Weigh ADT benefit against risk, especially in congenital long QT, CHF, or electrolyte disturbance. Avoid combination when possible; if required, correct and avoid hypokalemia/hypomagnesemia and monitor ECG and electrolytes periodically.
What happens
Increased risk of QT interval prolongation
Interaction Deep Dive
When goserelin is given alongside medications that prolong the QT interval, the effects on the QT interval are additive. The androgen deprivation produced by GnRH agonists or antagonists can itself lengthen the QT interval. In patients who have congenital long QT syndrome, congestive heart failure, or recurrent electrolyte disturbances, as well as in those receiving drugs recognized to prolong the QT interval, weigh whether the advantages of androgen deprivation therapy such as goserelin justify the possible hazards3. Where feasible, do not use goserelin together with QT prolonging agents. Should coadministration be necessary, refrain from using agents that produce electrolyte disturbances (that is, hypokalemia or hypomagnesemia)1, correct any electrolyte abnormalities, and consider periodic ECG and electrolyte monitoring3.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Keep taking both medicines exactly as prescribed unless your care team tells you otherwise. Because both can nudge your heart's QT interval, your team can manage this by:
- Deciding whether the benefits of goserelin outweigh the risks in your case, especially if you have a heart-rhythm condition, heart failure, or frequent electrolyte problems.
- Checking your heart tracing (ECG) and blood minerals (potassium, magnesium) from time to time, and correcting any that are low.
What to do: Tell your pharmacist or doctor you take both drugs. Report fainting, palpitations, or dizziness right away. Your dose and monitoring can be individualized to keep you safe.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In an analysis of male patients undergoing androgen deprivation therapy (ADT) using individual case safety reports from VigiBase, the international pharmacovigilance database, investigators identified 184 cases of acquired long-QT syndrome (aLQTS) and/or torsades de pointes (TdP; 11% fatal cases), along with 99 cases of sudden death linked to ADT. The majority of aLQTS/TdP cases (62%) and sudden death cases (88%) tied to ADT arose without concurrent use of other medications recognized to raise TdP risk; nevertheless, use of 1 drug and use of 2 or more drugs carrying conditional, possible, or known TdP risk was documented in a portion of aLQTS/TdP events (23% or 43%) and sudden death events (18% and 22%). The agents classified as ADTs included abiraterone, gonadotropin-releasing hormone agonists and antagonists, nonsteroidal androgen receptor inhibitors indicated for prostate cancer, and 5-alpha-reductase inhibitors indicated for androgenic alopecia and prostatism. Among the 10 ADTs assessed, 7 showed a disproportional association (reporting odds ratio, 1.4 to 4.7) with aLQTS, TdP, or sudden death, namely leuprorelin, goserelin, triptorelin, degarelix, bicalutamide, finasteride, and dutasteride. The median patient age was approximately 76 years, and the median time to onset was 170 days (range, 7 to 4884 days) for aLQTS/TdP events and 92 days (range, 0.25 to 4984 days) for sudden death events. Patients were taking ADT chiefly for prostate cancer, with some treated for prostatism and androgenic alopecia. Most patients were on ADT monotherapy (83%), while 17% were receiving ADT combination therapy 2.
Common questions
Can I take Goserelin and Amitriptyline together?
Amitriptyline and goserelin can both prolong the heart's QT interval, so together the risk adds up; keep taking both as prescribed and let your care team monitor your ECG and electrolytes. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Goserelin 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 Goserelin and Amitriptyline interaction managed?
Keep taking both medicines exactly as prescribed unless your care team tells you otherwise. Because both can nudge your heart's QT interval, your team can manage this by: Deciding whether the benefits of goserelin outweigh the risks in your case, especially if you have a heart-rhythm condition, heart failure, or frequent electrolyte problems. Checking your heart tracing (ECG) and blood minerals (p… 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 Goserelin 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 (3)
- Lyon AR, Lopez-Fernandez T, Couch LS, et al: 2022 ESC guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J 2022; 43(41):4229-4361.
- Salem JE, Yang T, Moslehi JJ, et al: Androgenic effects on ventricular repolarization: a translational study from the international pharmacovigilance database to iPSC-cardiomyocytes. Circulation 2019; 140(13):1070-1080. PubMed
- Product Information: ZOLADEX® subcutaneous implant, goserelin subcutaneous implant. TerSera Therapeutics LLC, Deerfield, IL, 2026. DailyMed
Keep reading about Amitriptyline
Keep reading about Goserelin
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