Can I take Amitriptyline and Naproxen together?

Why this happens

Amitriptyline belongs to a group of medicines that can affect how your blood platelets work. Naproxen is a non-steroidal anti-inflammatory drug (NSAID) that also thins the blood slightly and can irritate the lining of the stomach. When used together, these effects add up, making bleeding more likely.

What you should do

You can take these together if prescribed by your doctor, but you should be vigilant. Seek medical advice immediately if you notice signs of bleeding, such as vomit that looks like coffee grounds, very dark or 'tarry' stools, or unexplained bruising. If you need to take this combination long-term, your doctor may prescribe a 'stomach protector' medicine (like omeprazole) to reduce the risk.

Important precautions

Suicidal 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.

Asthma

Do not take naproxen if you have a history of asthma, hives, or allergic reactions triggered by aspirin or other NSAIDs, as it can cause a life-threatening allergic reaction or severe asthma attack.

Stomach ulcers or bleeding

Naproxen significantly increases the risk of serious stomach bleeding and ulcers. This risk is higher if you are over 65, have a history of stomach issues, or take other blood-thinning medications.

Heart rhythm disorders

Amitriptyline can affect your heart rhythm (QT prolongation). It must be used with extreme caution if you have a history of heart disease, recent heart attack, or are taking other medicines that affect heart rate.

Food and drink warnings

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 amounts of caffeine can worsen these effects and may also interfere with the sedative effect of the medicine, making it harder for you to sleep.

Food (General)

It is highly recommended to take naproxen with or just after food or a snack. This helps to protect your stomach lining and reduces the risk of indigestion or stomach pain.

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.