Can I take Amitriptyline and Tizanidine together?
Drug interaction guide
Originally published 25 Jan 2026
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Taking amitriptyline and tizanidine together can make you feel extremely drowsy, dizzy, and lightheaded. It can also cause a significant drop in blood pressure, which might lead to fainting. You may find it very difficult to concentrate or perform tasks that require alertness.
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Why this happens
Both drugs have a 'depressing' effect on the central nervous system (brain and nerves). When used together, these effects are added together (additive effect). Additionally, both medications can lower blood pressure and slow down your heart rate.
What you should do
Back to contentsYou should speak to your doctor before taking these two medicines together. If your doctor prescribes both, they may start you on a lower dose and monitor you closely. Do not drive or operate machinery until you know how this combination affects you. Seek medical help immediately if you feel very faint, confused, or have a very slow heartbeat.
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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.
Drowsiness and coordination
Both medicines cause significant drowsiness and slow your reactions. Taking them together greatly increases this effect, making it dangerous to drive, use tools, or operate machinery until you know how they affect you.
Liver or kidney problems
You must not take tizanidine if you have severe liver problems. If you have kidney issues, your doctor must start you on a very low dose, as the medicine can build up to dangerous levels in your body.
Heart conditions
Do not take amitriptyline if you have recently had a heart attack or have certain heart rhythm disorders (such as heart block), as it can affect the electrical signals in your heart.
Food and drink warnings
Back to contentsAlcohol
You must avoid or strictly limit alcohol while taking these medicines. Both amitriptyline and tizanidine 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)
Caffeine can interfere with how your body breaks down tizanidine. This can lead to higher levels of the medicine in your blood, increasing the risk of side effects like very low blood pressure, a slow heart rate, or extreme drowsiness.
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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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Can I take Amitriptyline and Esomeprazole together?
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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Article history
The information on this page is written and peer reviewed by qualified clinicians.
25 Jan 2026 | Originally published

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