Topiramate and Amitriptyline Interaction
Drug interaction information between Topiramate and Amitriptyline.
Topiramate and Amitriptyline have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Topiramate and Amitriptyline. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.
How They Interact
Topiramate can cause the amount of amitriptyline in your blood to rise significantly.
FDA Label Information
7.8 Amitriptyline Some patients may experience a large increase in amitriptyline concentration in the presence of topiramate and any adjustments in amitriptyline dose should be made according to the patient's clinical response and not on the basis of plasma levels [see Clinical Pharmacology ( 12.3 )] .
Topiramate Also Interacts With
- Zonisamide moderate
- Alogliptin moderate
- Ertugliflozin moderate
- Hydrochlorothiazide minor
- Pioglitazone minor
Amitriptyline Also Interacts With
- Risperidone major
- Sertraline minor
- Fluoxetine minor
- Paroxetine minor
- Disulfiram minor
Frequently Asked Questions
What SPL severity band is on file for Topiramate + Amitriptyline?
Compiled FDA labeling labels this pair minor. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Topiramate has 30 labeled pairs on file vs Amitriptyline's 21. In the minor band specifically: Topiramate has 27 (also Hydrochlorothiazide, Pioglitazone, Carbamazepine, Lithium); Amitriptyline has 20 (also Sertraline, Fluoxetine, Paroxetine, Disulfiram).
What mechanism field is on file for Topiramate and Amitriptyline?
Topiramate can cause the amount of amitriptyline in your blood to rise significantly.
Amitriptyline carries more major-labeled pairs than Topiramate
SPL source-record counts only. This page's band is minor · classes on file: Topiramate (Anticonvulsant); Amitriptyline (Tricyclic Antidepressant (TCA)).
Amitriptyline has 1 major-labeled pair vs Topiramate's 0. This page itself is in the minor band, not the major band.
0 major · 3 moderate · 27 minor · 30 total
- Other minor peers for Topiramate
- Hydrochlorothiazide
- Pioglitazone
- Carbamazepine
- Lithium
1 major · 0 moderate · 20 minor · 21 total
- Other minor peers for Amitriptyline
- Sertraline
- Fluoxetine
- Paroxetine
- Disulfiram
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.
Read our methodology - how this data is sourced, computed, and verified.