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An inquest into the death of a woman who suffered a heart attack after taking an antidepressant and heart medication warned prescribers to be more aware of the risks of combining the two drugs.

Chloe Burgess was found dead at home in Southampton in September 2023 having suffered cardiac arrhythmia and sudden cardiac death after taking amitriptyline, paroxetine and ivabradine.

The coroner Nicholas Walker said it was “likely” her heart medication, prescribed after a diagnosis of sinus tachycardia and left bundle branch block, interacted with her antidepressant medication to raise levels of amitriptyline in her blood.

The inquest heard the combination of the two drugs, as well as an episode of sleep apnoea, led to her death. It also heard Ms Burgess had been using the combination of drugs for four years before she died “without concern”.

“The potential dangers of the combination of drugs in Chloe’s case was not well-known or appreciated by those treating her,” Walker said in his report into her death.

Evidence presented to the inquest revealed the potential dangers of combining amitriptyline, paroxetine and ivabradine “does not trigger an alert on the prescribing software used in primary care or by pharmacists”.

“The potential dangers related to a failure to metabolise amitriptyline which can, incrementally, lead to toxicity,” Walker said.

“I am also concerned that those prescribing ivabradine should have a full understanding of the potential interaction with amitriptyline and paroxetine.”

He gave the National Institute for Health and Care Excellence, the British National Formulary and the Royal College of Physicians until April 28 to respond to his report.