Lornoxicam 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
Lornoxicam
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 (an antidepressant) and lornoxicam (an anti-inflammatory pain reliever, a type of NSAID). Taken together, these two can raise your risk of bleeding. That's because anti-inflammatory drugs can irritate the stomach lining, and this class of antidepressant can affect how well your blood clots. In rare cases the concern includes serious bleeding, even in the brain, especially in the first month of using both.
Please don't stop either medicine on your own. This is something your care team can manage well by watching you closely. Let your pharmacist or doctor know if you notice unusual bruising, black or bloody stools, vomit that looks like coffee grounds, or a sudden bad headache.
Effect: Increased bleeding risk (including reports of intracranial hemorrhage, notably within 30 days of concurrent use) when a TCA (amitriptyline) is combined with an NSAID (lornoxicam).
- Direction: Additive bleeding risk (pharmacodynamic), not a change in either drug's effect.
- Mechanism: Unknown/unclear; likely additive effects on hemostasis plus NSAID GI mucosal injury and antiplatelet action.
- Onset: Unspecified; risk noted early in therapy.
- Evidence: Established. Severity: Major.
- Management: Use with caution; monitor for GI and other bleeding (Hgb/Hct, stool, neuro symptoms). Consider gastroprotection or an alternative analgesic per clinical judgment.
What happens
An increased risk of bleeding
Interaction Deep Dive
Exercise caution when NSAIDs and tricyclic antidepressants are administered together, since this combination may heighten the risk of bleeding, such as intracranial hemorrhage occurring within 30 days of concurrent use1. If these agents are taken at the same time, watch the patient for indications of increased bleeding.
Why it happens (mechanism)
Unknown
How to manage this interaction
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. This combination is manageable with caution and closer attention.
- Your care team may monitor you more closely for signs of bleeding, especially early in treatment.
- They may weigh options such as choosing a different pain reliever or adding stomach protection, based on your overall risk.
- Watch for and promptly report: unusual bruising, black or bloody stools, vomit resembling coffee grounds, blood in urine, or a sudden severe headache.
Ask your pharmacist or doctor before adding other pain relievers or blood thinners, since these can add to the risk.
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 greater risk of intracranial hemorrhage within 30 days of concurrent use than antidepressant use by itself. No meaningful difference was found among the antidepressant drug classes with respect to this elevated risk; however, an increased risk was seen in male patients relative to female patients 1.
Common questions
Can I take Lornoxicam and Amitriptyline together?
Combining amitriptyline with the NSAID lornoxicam raises bleeding risk, so keep taking both as prescribed but watch for signs of bleeding and report them to your pharmacist or doctor right away. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lornoxicam 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 Lornoxicam and Amitriptyline interaction managed?
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. This combination is manageable with caution and closer attention. Your care team may monitor you more closely for signs of bleeding, especially early in treatment. They may weigh options such as choosing a different pain reliever or adding stomach protection, based on your overall risk. Watch for and promptly repo… 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 Lornoxicam 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 Lornoxicam
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