Moderate
Amitriptyline × Indapamide
Tricyclic antidepressants (TCA)×Thiazide-like diuretics
Mechanism
Additive orthostatic hypotension and hypokalaemia risk. Older patients: delirium risk with thiazide-like diuretic hypovolaemia.
Symptoms
Postural dizziness, syncope, fatigue. Older patients: fall and fracture risk.
Management
In older patients, check standing and sitting blood pressure, assess potassium and sodium. 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.