Amitriptyline × Losartan

ModerateTricyclic antidepressants (TCA)×Angiotensin II receptor blockers (sartans)

Updated 22 May 2026 · Methodology

Mechanism

Additive orthostatic hypotension. Losartan (ARB) dilates vessels; amitriptyline blocks α1-adrenoceptors. Older patients: fall risk.

Symptoms

Postural dizziness, syncope, fatigue. Older patients: fall and fracture risk.

Management

In older patients, check standing and sitting blood pressure 1–2 weeks after starting amitriptyline. For neuropathic pain, alternative: gabapentin or pregabalin.

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Sources

FDA: Amitriptyline HCl tablets prescribing information (2014)– ; DailyMed setid 4e520c63-1cf6-40f6-a51c-3f9b0e181342

Other interactions with Amitriptyline

Amitriptyline × Methylthioninium chloride (methylene blue)
Antidotes (V03AB17). The drug has one FDA-approved indication – methaemoglobinaemia. Biohacker use is off-label.
critical
Amitriptyline × Selegiline
Selective irreversible MAO-B inhibitor
critical
Amitriptyline × Ciprofloxacin
Fluoroquinolone antibacterials
major
Amitriptyline × Fluoxetine
Selective serotonin reuptake inhibitors
major
Amitriptyline × Morphine
Natural opium alkaloids
major
Amitriptyline × Metoprolol
Selective β1-adrenoceptor blockers
moderate
Amitriptyline × Mirtazapine
Other antidepressants (NaSSA)
moderate
Amitriptyline × Warfarin
Vitamin K antagonist anticoagulants
moderate

Other interactions with Losartan

Losartan × Captopril
ACE inhibitor
major
Losartan × Celecoxib
Selective COX-2 inhibitor (coxib)
major
Losartan × Co-trimoxazole
Sulfonamide-trimethoprim combination
major
Losartan × Enalapril
Angiotensin-converting enzyme inhibitors (ACEi)
major
Losartan × Hydrochlorothiazide
Thiazide diuretics
major
Losartan × Spironolactone
Potassium-sparing diuretics (mineralocorticoid receptor antagonists)
major
Losartan × Amlodipine
Calcium channel blockers (dihydropyridines)
moderate
Losartan × Metformin
Biguanides. Oral antihyperglycemic agents
moderate

Mechanism

Symptoms

Management

Check the full regimen, not just this pair

Sources

Other interactions with Amitriptyline

Amitriptyline × Methylthioninium chloride (methylene blue)

Amitriptyline × Selegiline

Amitriptyline × Ciprofloxacin

Amitriptyline × Fluoxetine

Amitriptyline × Morphine

Amitriptyline × Metoprolol

Amitriptyline × Mirtazapine

Amitriptyline × Warfarin

Other interactions with Losartan

Losartan × Captopril

Losartan × Celecoxib

Losartan × Co-trimoxazole

Losartan × Enalapril

Losartan × Hydrochlorothiazide

Losartan × Spironolactone

Losartan × Amlodipine

Losartan × Metformin