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Can I take Amitriptyline and Ramipril together?

Drug interaction guide

Taking amitriptyline and ramipril together can cause your blood pressure to drop lower than intended. This is most common when you first start the medication or when your dose is increased. You may feel dizzy, lightheaded, or faint, especially when standing up quickly from a sitting or lying position.

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Why this happens

Both medications have the side effect of lowering blood pressure. Ramipril is designed to do this by relaxing blood vessels, while amitriptyline can interfere with the body's natural reflexes that maintain blood pressure when you change position. When used together, these effects add up.

It is usually safe to take these together, but you should be cautious. To prevent dizziness, try to get up slowly from a bed or chair. If you feel very dizzy, sit or lie down immediately. Monitor your blood pressure at home if possible and tell your doctor if you feel constantly lightheaded or if you have a fainting spell.

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Pregnancy

You must not take ramipril if you are pregnant or planning to become pregnant, as it can cause serious harm or death to an unborn baby, particularly affecting their kidney development.

Suicidal thoughts

Amitriptyline can increase thoughts of self-harm or suicide, especially when first starting treatment or changing doses; you must inform a doctor immediately if your mood changes or you feel distressed.

Angioedema (Severe Swelling)

Stop taking ramipril and seek emergency help if you experience swelling of the face, lips, tongue, or throat, as this can be a life-threatening allergic reaction.

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.

Salt substitutes (Potassium-based)

Ramipril can increase the levels of potassium in your blood. Using salt substitutes that contain potassium (such as Lo-Salt) can cause your potassium levels to become dangerously high. Check with your pharmacist before using these.

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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.

Article history

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

  • 25 Jan 2026 | Originally published
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