What the FDA labels say about taking them together
Amitriptyline and topiramate
Amitriptyline's FDA label of September 8, 2026 names topiramate in its drug interactions section, and topiramate's label names amitriptyline too. The topiramate label: “Some patients may experience a large increase in amitriptyline concentration in the presence of TROKENDI XR and any adjustments in amitriptyline dose should be made according to the patients' clinical response and not …”
Check it at the source: the amitriptyline FDA label on DailyMed (effective September 8, 2026, Sun Pharmaceutical Industries, Inc.); the topiramate FDA label on DailyMed (effective June 1, 2026, Sun Pharmaceutical Industries, Inc.).
What does the amitriptyline label say about topiramate?
Amitriptyline label, drug interactionsDrug Interactions Topiramate 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.
Source: FDA drug label (Amitriptyline Hydrochloride), Sun Pharmaceutical Industries, Inc., effective September 8, 2026 (SPL set 4e520c63-1cf6-40f6-a51c-3f9b0e181342), via openFDA; the full label on DailyMed
What does the topiramate label say about amitriptyline?
Topiramate label, drug interactionsSome 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) ].
Source: FDA drug label (Qudexy Xr, NDA205122), Upsher-Smith Laboratories, LLC, effective September 3, 2026 (SPL set 46f54677-3a22-4c38-9b92-923020164e15), via openFDA
Source: FDA drug label (Trokendi Xr, NDA201635), Supernus Pharmaceuticals, Inc., effective March 20, 2026 (SPL set 2dc7957e-a3e5-46bb-aa66-f3250f872f5e), via openFDA
Source: FDA drug label (Topiramate), Sun Pharmaceutical Industries, Inc., effective June 1, 2026 (SPL set 3c909a53-ae66-4b28-a741-b60bb25a69cf), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Amitriptyline | Topiramate | |
|---|---|---|
| Labeled for | Depression | Seizures and epilepsy, Migraine |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $0.03 per tablet 10 mg tablet | $0.0567 per tablet 100 mg tablet |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once