Oxaliplatin 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
Oxaliplatin
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.
Both of these medicines can affect your heart's rhythm. Amitriptyline (Elavil), an older antidepressant, and oxaliplatin, a chemotherapy drug, can each stretch out a part of your heartbeat called the QT interval. When you take them together, that effect can add up and, in rare cases, lead to a dangerous irregular heartbeat.
This concern is based mostly on theory rather than lots of real-world reports, so try not to worry. Please don't stop either medicine on your own. Your cancer team and pharmacist know how to watch for this. Let them know you take both so they can keep an eye on your heart and adjust things if needed.
Interaction: Additive QT-interval prolongation from combined amitriptyline and oxaliplatin.
- Mechanism: Both agents independently prolong cardiac repolarization (QT); effects are additive (pharmacodynamic, not PK). Neither is a prodrug relevant here.
- Direction/effect: Increased risk of QT prolongation and torsades de pointes/ventricular arrhythmia.
- Evidence: Theoretical; severity rated major. Onset unspecified.
- Management: Avoid concomitant use where feasible. If both required, obtain baseline and periodic ECGs, correct electrolytes (K+, Mg2+), review other QT-prolonging agents, and monitor for syncope/palpitations. Dose may need individualization by the care team.
What happens
Increased risk of QT-interval prolongation
Interaction Deep Dive
Prolongation of the QT interval and ventricular arrhythmias are possible adverse effects of oxaliplatin. Its use together with other agents recognized as having the capacity to lengthen the QT interval should be avoided1.
Why it happens (mechanism)
Additive QT-interval prolongation
How to manage this interaction
The main strategy is caution and monitoring. Where possible, teams try to avoid combining two QT-prolonging drugs, but sometimes both are needed.
- Keep taking both exactly as prescribed unless your team tells you otherwise.
- Your care team may check your heart rhythm (ECG) and keep an eye on it during treatment.
- They may also check blood levels like potassium and magnesium, since low levels add to the risk.
- The dose may be adjusted and individualized by your care team.
Tell your pharmacist or doctor if you feel fainting, dizziness, or a pounding or irregular heartbeat, and make sure they know you take both medicines.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Oxaliplatin and Amitriptyline together?
Amitriptyline and oxaliplatin can both prolong the QT interval, so combining them may raise the risk of a dangerous heart rhythm. Don't change anything yourself; let your care team decide on monitoring or alternatives. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Oxaliplatin 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 Oxaliplatin and Amitriptyline interaction managed?
The main strategy is caution and monitoring. Where possible, teams try to avoid combining two QT-prolonging drugs, but sometimes both are needed. Keep taking both exactly as prescribed unless your team tells you otherwise. Your care team may check your heart rhythm (ECG) and keep an eye on it during treatment. They may also check blood levels like potassium and magnesium, since low levels add to t… 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 Oxaliplatin 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: ELOXATIN(R) intravenous injection, oxaliplatin intravenous injection. sanofi-aventis US LLC (per FDA), Bridgewater, NJ, 2020. DailyMed
Keep reading about Amitriptyline
Keep reading about Oxaliplatin
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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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