Can I take Amitriptyline and Nustendi together?

Why this happens

Amitriptyline is an antidepressant that can occasionally cause muscle-related side effects. Nustendi contains bempedoic acid and ezetimibe; bempedoic acid is known to increase the levels of certain cholesterol medications (statins) which cause muscle pain, though it does not directly interact with amitriptyline's metabolism in the liver.

What you should do

It is generally safe to take these two medications together. However, you should inform your doctor if you experience any unexplained muscle pain, tenderness, or weakness while taking this combination. Always ensure your doctor is aware of all medications you are taking.

Important precautions

Suicidal thoughts and mood changes

Amitriptyline can increase the risk of suicidal thoughts or self-harm, particularly when first starting treatment or changing doses. Seek immediate medical help if your mood changes or you feel depressed.

Pregnancy

You must not take Nustendi if you are pregnant or breastfeeding. If you are a woman who could become pregnant, you must use effective contraception while taking it. Stop taking it immediately and tell your doctor if you become pregnant.

Gout

Nustendi can increase the levels of uric acid in your blood, which may cause gout. Tell your doctor if you have ever had gout or if you develop painful, swollen joints.

Glaucoma (Acute Angle-Closure)

Amitriptyline can significantly increase pressure inside the eye. If you have a history of glaucoma, you must discuss this with your doctor as it could trigger an acute attack.

Heart Rhythm Disorders

Amitriptyline can affect your heart rhythm (QT prolongation). It must be used with extreme caution if you have a history of heart block or have recently had a heart attack.

Food and drink warnings

Alcohol

Drinking alcohol while taking amitriptyline can make you feel very sleepy and unsteady on your feet. It is best to avoid alcohol, especially when you first start treatment or if your dose is increased.

Caffeine (Coffee, Tea, Energy Drinks)

Amitriptyline can sometimes make you feel jittery or affect your sleep. High amounts of caffeine may worsen these side effects or interfere with the medicine's calming effect.

Grapefruit juice

While Nustendi does not have a direct major interaction with grapefruit, it is often prescribed alongside statins (like simvastatin or atorvastatin). If you take a statin with Nustendi, grapefruit juice can increase the level of the statin in your blood, increasing the risk of side effects. Check if you are also taking a statin.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.