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Can I take Amitriptyline and Gabapentin together?

Drug interaction guide

Taking amitriptyline and gabapentin together can make you feel very sleepy, dizzy, or confused. It can also make it harder to concentrate and may slow down your breathing or affect your coordination, increasing the risk of falls.

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Why this happens

Both medicines work by slowing down activity in the central nervous system (the brain and nerves). When used together, their sedative effects add up, making the overall impact on your body much stronger than if you took either medicine alone.

What you should do

Use this combination with caution. Do not drive, operate heavy machinery, or perform dangerous tasks until you know how these medicines affect you. Avoid drinking alcohol, as it will make the sleepiness much worse. If you feel extremely drowsy, have trouble breathing, or feel very unsteady on your feet, contact your doctor immediately.

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Important precautions

Suicidal thoughts and mood changes

Both medicines 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.

Severe breathing problems (Respiratory Depression)

Gabapentin can cause serious, life-threatening breathing difficulties, especially if you already have lung disease, are elderly, or take other sedating medicines like opioids. Seek emergency care if you experience shallow breathing or extreme sleepiness.

Heart rhythm disorders (QT prolongation)

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 are taking other medicines that affect the heart's electrical signals.

Food and drink warnings

Alcohol

You should avoid or strictly limit alcohol while taking these medicines. Both amitriptyline and gabapentin 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

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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