Can I take Amitriptyline and Pregabalin together?
Drug interaction guide
Originally published 25 Jan 2026
Meets Patient’s editorial guidelines
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Taking amitriptyline and pregabalin together can make you feel very sleepy, dizzy, and unsteady on your feet. It can also cause significant confusion, difficulty concentrating, and may slow down your breathing.
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Why this happens
Both medicines work by slowing down activity in the central nervous system. When used together, their sedative effects add up (an additive effect), making the side effects much stronger than if you took either medicine alone.
What you should do
Back to contentsUse this combination with caution. Do not drive, cycle, or operate heavy machinery until you know how these medicines affect you. Avoid drinking alcohol, as it will make the sleepiness much worse. If you feel extremely drowsy or have trouble breathing, seek medical help immediately. Your doctor may need to adjust your doses.
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Important precautions
Back to contentsSuicidal thoughts and mood changes
Amitriptyline can increase the risk of suicidal thoughts or self-harm, particularly when first starting treatment or changing doses. Seek immediate medical help if your mood changes or you feel depressed.
Central Nervous System Depression
Both medicines cause significant drowsiness. Combining them, or taking them with alcohol, greatly increases the risk of severe sedation and breathing difficulties. Do not drive or operate machinery until you know how they affect you.
Heart Conditions
Amitriptyline can affect your heart rhythm. It must be used with extreme caution if you have a history of heart disease, a recent heart attack, or an irregular heartbeat.
Drug Dependency and Withdrawal
Pregabalin carries a risk of dependence and misuse. Do not stop taking it suddenly, as this can cause serious withdrawal symptoms such as seizures; the dose must be reduced gradually.
Food and drink warnings
Back to contentsAlcohol
You should avoid or strictly limit alcohol while taking these medicines. Both amitriptyline and pregabalin cause drowsiness and dizziness; alcohol significantly increases these effects, which can lead to dangerous levels of sedation, impaired coordination, and breathing difficulties.
Caffeine (Coffee, Tea, Energy Drinks)
Amitriptyline can sometimes cause a fast or irregular heartbeat. High amounts of caffeine can worsen these side effects and may also interfere with the sedative effect of the medicine if you are taking it to help with sleep.
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Using other medicines
Back to contentsTaking 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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