Can I take Amitriptyline and Pregabalin together?

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

Use 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.

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.

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.

Pregnancy

Pregabalin use during the first three months of pregnancy may increase the risk of birth defects. Effective contraception must be used during treatment.

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

Alcohol

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.

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.