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Can I take Amitriptyline and Esomeprazole together?

Drug interaction guide

Taking esomeprazole alongside amitriptyline may increase the levels of amitriptyline in your bloodstream. This could make you more likely to experience side effects such as extreme sleepiness, a dry mouth, blurred vision, constipation, or a fast heartbeat.

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Why this happens

Amitriptyline is broken down in the liver by specific proteins (enzymes). Esomeprazole can slow down the activity of these proteins, which means the amitriptyline stays in your system longer and reaches higher levels than intended.

You can take these medicines together, but you should be aware of the potential for increased side effects. If you feel unusually drowsy, dizzy, or notice your heart racing, speak to your doctor. They may decide to adjust your dose of amitriptyline.

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Suicidal thoughts and behaviour

Amitriptyline can increase thoughts of self-harm or suicide, particularly when first starting treatment or changing doses. Seek immediate medical help if your mood changes or you have distressing thoughts.

Glaucoma (specifically acute angle-closure glaucoma

Do not take amitriptyline if you have a history of narrow-angle glaucoma, as it can cause a sudden, dangerous increase in eye pressure.

Severe bacterial diarrhoea (C. difficile)

Esomeprazole reduces stomach acid, which can increase your risk of serious gut infections. Seek medical advice if you develop severe or persistent watery diarrhoea, stomach pain, and fever.

Alcohol

Drinking alcohol while taking amitriptyline can make you feel very sleepy and unsteady on your feet. It is best to avoid alcohol, especially when you first start treatment or if your dose is increased.

Caffeine (Coffee, Tea, Energy Drinks)

Amitriptyline can sometimes cause a fast or irregular heartbeat. High intake of caffeine can worsen these side effects and may also interfere with the sedative effect of the medicine.

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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.

  • 25 Jan 2026 | Originally published
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