Solifenacin 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
Solifenacin
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) and solifenacin (Vesicare) can each slightly stretch out a part of the heartbeat called the QT interval. When you take them together, that effect can add up, which in rare cases can lead to a dangerous irregular heartbeat.
The good news is this is mostly a theoretical concern, and many people take medicines like these safely. Your care team can keep an eye on things, sometimes with a simple heart tracing called an EKG. Please don't stop either medicine on your own. Just check in with your pharmacist or doctor, especially if you feel dizzy, faint, or notice a fluttering heartbeat.
Interaction: Additive QT-interval prolongation when amitriptyline is combined with solifenacin, increasing theoretical risk of ventricular arrhythmias including torsade de pointes.
- Mechanism: Pharmacodynamic (additive), not a metabolic/enzyme interaction. Both agents independently prolong the QT interval.
- Direction/magnitude: Additive QTc effect; magnitude not quantified.
- Evidence: Theoretical; onset unspecified. Severity rated major.
- Management: Use caution. If coadministered, obtain baseline and periodic ECG, monitor QTc, and correct electrolytes (K+, Mg2+). Assess additional QT-prolonging drugs and risk factors.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
Caution is advised when solifenacin is taken together with other QT-prolonging agents such as amitriptyline, since combining them may produce additive QT interval prolongation and heighten the risk of serious ventricular arrhythmias, torsade de pointes among them1. Should such combined use be necessary, monitoring for QT interval prolongation may be warranted.
Why it happens (mechanism)
Additive effects on QT interval prolongation
How to manage this interaction
Keep taking both medicines as prescribed unless your care team tells you otherwise. This is a caution, not a ban on using them together.
- Your team may check your heart rhythm with an EKG before and during treatment.
- They may review any other medicines you take that also affect the QT interval.
- Doses may be adjusted and individualized by your care team, and they may monitor you more closely.
Call your pharmacist or prescriber if you feel faint, dizzy, have palpitations, or notice an irregular heartbeat. Ask them to review your full medication list.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Solifenacin and Amitriptyline together?
Taking amitriptyline and solifenacin together can add up their effects on heart rhythm (QT prolongation), so let your care team monitor you, but don't stop either drug on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Solifenacin 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 Solifenacin and Amitriptyline interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. This is a caution, not a ban on using them together. Your team may check your heart rhythm with an EKG before and during treatment. They may review any other medicines you take that also affect the QT interval. Doses may be adjusted and individualized by your care team, and they may monitor you more closely. Call y… 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 Solifenacin 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: VESIcare(R) oral tablets, solifenacin succinate oral tablets. Astellas Pharma US, Inc, Deerfield, IL, 2011. DailyMed
Keep reading about Amitriptyline
Keep reading about Solifenacin
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.
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