Drug & supplement interaction

Catechu + Amitriptyline

Amitriptyline brand name: Elavil.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Catechu has a moderate interaction with Amitriptyline. Theoretically, black catechu may increase the levels and clinical effects of CYP1A2 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Catechu and Amitriptyline

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Amitriptyline

Amitriptyline falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Catechu interacts with.

Theoretically, black catechu may increase the levels and clinical effects of CYP1A2 substrates.
Animal research shows that black catechu can increase theophylline concentrations in the blood, possibly by inhibiting CYP1A2. Theophylline is a CYP1A2 substrate.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: your body partly uses an enzyme called CYP1A2 to break down amitriptyline. Catechu is rich in tannins that, in lab and animal studies, appear to slow that same enzyme down. If amitriptyline clears more slowly, more of it can linger in your system, which could mean stronger effects and more of its usual side effects like drowsiness, dry mouth, constipation, blurry vision, dizziness when standing, or a faster heartbeat.

I want to be honest about the evidence though. This is theoretical, based only on lab and animal data, not on real people taking these two together. So I'm not raising alarm bells. Still, before you add concentrated catechu supplements, please run it by your pharmacist or doctor so they can keep an eye on how you feel.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Al-Mohizea AM, Raish M, Ahad A, et al. Pharmacokinetic interaction of Acacia catechu with CYP1A substrate theophylline in rabbits. J Tradit Chin Med 2015;35(5):588-93. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Catechu Also Interacts With Other Medications

Catechu has 474 moderate known drug interactions in our database — the Amitriptyline one above is one of them. If you take anything else, check it against the full list below.

Moderate 474 No known interaction 2,356 (incl. Amitriptyline)
Taking anything else?

Check Another of Your Medications Against Catechu

Covers the 2,830 medications we’ve checked against Catechu. Pick one to open its full report.

From our Q&A

Questions About Catechu or Amitriptyline

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Catechu or Amitriptyline, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Amitriptyline

This page covers Catechu only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline page lists 296 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).

By severity: 17 major · 228 moderate · 51 minor.

From our pharmacist’s overview on the Amitriptyline page

“Amitriptyline (Elavil), an older antidepressant now often prescribed for nerve pain, migraines, and sleep, is one of the drugs I genuinely want patients to be careful with, and 17 of the 296 supplement and herbal ingredients on this list carry a major rating. Most of the serious ones deepen the drowsiness amitriptyline already causes,…”

Reviewed by 2 · Jul 18, 2026

Open the Amitriptyline interaction page

One more smart check

Taking Catechu as Part of a Dietary Supplement Product? Check It for Interactions

We hold 122 real supplement products containing Catechu, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Catechu. Your product may carry other ingredients that interact with Amitriptyline too, on top of Catechu — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Catechu and Amitriptyline Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Catechu
Top half

#480 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Amitriptyline
Top 5%

#45 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Catechu

What is Catechu?

Catechu
  • Mouth and throat soreness
  • Diarrhea and digestive upset
  • Skin wounds and bleeding gums
  • Astringent gargles and rinses
  • Traditional remedy for inflammation

Catechu is an astringent extract made from the heartwood of the Acacia (Senegalia) catechu tree, used traditionally for mouth sores, sore throat, diarrhea, and minor skin problems. Strong human evidence is lacking for most uses, so it should be viewed as a traditional remedy rather than a proven treatment. Talk to your pharmacist or doctor before using it, especially if you are pregnant, breastfeeding, or taking other medicines.

Read the full Catechu monograph & all interactions
Medication

About Amitriptyline

What Is Amitriptyline Used For?

Brand name: Elavil

Amitriptyline HCL and Amitriptyline Hydrochloride tablets are used to relieve symptoms of depression. Depression that originates from within the body (called endogenous depression) tends to respond better than other types of depression.

See full Amitriptyline drug information
Keep checking

Other Drugs & Catechu

Browse every other medication we’ve checked against Catechu — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
474Moderate
0Minor
2,355No known interaction
474 Moderate 2,355 No interaction
Moderate

474 interactions

Showing 60 of 474 moderate interactions — see all 474 on the Catechu page.

No interaction 2,355 drugs checked — show the list

We also checked Catechu against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,355 medications checked with no known interaction — see the full Catechu list.

See the full Catechu interactions page
See every supplement checked against Amitriptyline, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Catechu monograph › Uses, safety, and every drug interaction in one place Amitriptyline supplement interactions › Every supplement checked against Amitriptyline, ranked by severity Amitriptyline drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Catechu and Amitriptyline Together: Common Questions

Can you take Catechu with Amitriptyline?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Catechu and Amitriptyline interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Amitriptyline and Catechu?

Our pharmacists answer your medication & supplement questions — free.

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.