ModerateTricyclic antidepressants (TCA)×Thiazide diuretics
Updated · Methodology
Mechanism
Additive orthostatic hypotension. Older patients: fall and delirium risk with thiazide-induced hypovolaemia.
Symptoms
Postural dizziness, syncope, fatigue. Older patients: fall and fracture risk.
Management
In older patients, check standing and sitting blood pressure and assess fluid and electrolyte balance. For neuropathic pain, alternative: gabapentin or pregabalin.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Amitriptyline HCl tablets prescribing information (2014)– ; DailyMed setid 4e520c63-1cf6-40f6-a51c-3f9b0e181342
- AEMPS: Ficha técnica: Amitriptilina (nº registro 89862), sección 4.5 (2026)– AEMPS, CIMA, nº registro 89862, revisión 05/2026, sección 4.5
- AEMPS: Ficha técnica: Hidroclorotiazida (nº registro 86487), sección 4.5 (2026)– AEMPS, CIMA, nº registro 86487, revisión 09/2026, sección 4.5