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Can I take Amitriptyline and Tramadol together?

Drug interaction guide

Taking these two medicines together can increase the risk of a rare but serious condition called 'serotonin syndrome'. It can also increase the risk of having a seizure (a fit). Additionally, both drugs can make you feel very drowsy, dizzy, or confused, which increases the risk of falls.

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Why this happens

Both amitriptyline and tramadol increase the levels of a chemical called serotonin in the brain. If levels get too high, it causes serotonin syndrome. Furthermore, both drugs lower the 'seizure threshold', making a fit more likely. Tramadol is also broken down by the same liver enzymes that amitriptyline uses, which can lead to higher levels of the drugs in your system.

You should only take these two medicines together if they have been specifically prescribed by a doctor who is aware you are taking both. Seek immediate medical help if you experience extreme agitation, hallucinations, a very fast heartbeat, high fever, muscle twitching, or shivering. Avoid driving or operating machinery until you know how this combination affects you.

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Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.

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Article history

The information on this page is written and peer reviewed by qualified clinicians.

  • 14 Mar 2026 | Originally published
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