Dosing & Uses
Dosage Forms & Strengths
capsule
- 10mg
- 25mg
- 50mg
- 75mg
oral solution
- 10mg/5mL
Depression
25mg PO q6-8hr
No more than 150 mg/day
Dosing considerations
- Total daily dose can be given HS
- To discontinue therapy, gradually taper dose to minimize incidence of withdrawal symptoms and allow for detection of re-emerging symptoms
Chronic Urticaria, Nocturnal Pruritus, Angioedema (Off-label)
75mg/day PO
Smoking Cessation (Off-label)
25 mg PO qDay; start 1-2 weeks before quit date; may titrate to 75-100 mg/day 10-28 days prior to selected quit date; titrate dose to 75-100 mg/day; continue therapy for 12 weeks or more after quit day
ADHD (Off-label)
25 mg PO q6-8hr
Postherpetic Neuralgia (Off-label)
10-25 mg PO qHS; may increase q3-5days in 10 mg increments qDay up to 160 mg qHS or divided q12hr if tolerated
Dosing Modifications
Hepatic impairment: Administer lower dose and titrate at a slower rate
Dosage Forms & Strengths
capsule
- 10mg
- 25mg
- 50mg
- 75mg
oral solution
- 10mg/5mL
Depression (Off-label)
<6 years: Safety and efficacy not established
6-12 years: 1-3 mg/kg/day PO divided q6-8hr, OR 10-20 mg/day PO divided q6-8hr
>12 years: 30-50 mg PO qDay, divided or single dose
See Black Box Warning
Nocturnal Enuresis (Off-label)
6-7 years (20-25 kg): 10 mg PO qHS
8-11 years (26-35 kg): 10-20 mg PO qHS
>11 years (36-54 kg): 25-35 mg PO qHS
ADHD (Off-label)
0.5 mg/kg/day PO, titrated to maximum 2 mg/kg/day or 100 mg, whichever is less
Depression
Initial: 30-50 mg PO qDay or in divided doses
May increase to 75-100 mg/day if tolerated
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (17)
- disopyramide
nortriptyline and disopyramide both increase QTc interval. Contraindicated.
- dronedarone
dronedarone will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.
- ibutilide
nortriptyline and ibutilide both increase QTc interval. Contraindicated.
- indapamide
nortriptyline and indapamide both increase QTc interval. Contraindicated.
- iobenguane I 123
nortriptyline decreases effects of iobenguane I 123 by pharmacodynamic antagonism. Contraindicated. If clinically appropriate, discontinue drugs that decrease uptake of NE for at least 5 half-lives; may cause false-negative imaging results.
- isocarboxazid
isocarboxazid and nortriptyline both increase serotonin levels. Contraindicated.
- pentamidine
nortriptyline and pentamidine both increase QTc interval. Contraindicated.
- phenelzine
phenelzine and nortriptyline both increase serotonin levels. Contraindicated.
- pimozide
nortriptyline and pimozide both increase QTc interval. Contraindicated.
- procainamide
nortriptyline and procainamide both increase QTc interval. Contraindicated.
- procarbazine
procarbazine and nortriptyline both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.
- quinidine
quinidine and nortriptyline both increase QTc interval. Contraindicated.
- safinamide
nortriptyline, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.
- selegiline
selegiline and nortriptyline both increase serotonin levels. Contraindicated. Concurrent use or use within 14 days of selegiline treatment is contraindicated
- sotalol
nortriptyline and sotalol both increase QTc interval. Contraindicated.
- thioridazine
thioridazine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.
- tranylcypromine
tranylcypromine and nortriptyline both increase serotonin levels. Contraindicated.
Serious - Use Alternative (143)
- adagrasib
adagrasib, nortriptyline. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.
- albuterol
nortriptyline, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- amiodarone
nortriptyline and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.
- amitriptyline
amitriptyline and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
amitriptyline and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - amoxapine
amoxapine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
amoxapine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - arformoterol
nortriptyline, arformoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- arsenic trioxide
nortriptyline and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
artemether and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- artemether/lumefantrine
artemether/lumefantrine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
nortriptyline and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. - benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and nortriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- benzphetamine
nortriptyline, benzphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- buprenorphine
buprenorphine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine subdermal implant and nortriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate - buprenorphine transdermal
buprenorphine transdermal and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine transdermal and nortriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate - buprenorphine, long-acting injection
buprenorphine, long-acting injection and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
buprenorphine, long-acting injection and nortriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate - buspirone
nortriptyline and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.
- calcium/magnesium/potassium/sodium oxybates
nortriptyline, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- chlorpromazine
chlorpromazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- citalopram
citalopram and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Citalopram may increase TCA levels. Increased risk of serotonin syndrome or neuroleptic malignant syndrome. Potential risk for QT prolongation. ECG monitoring is recommended.
citalopram and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. - clarithromycin
nortriptyline and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.
- clomipramine
clomipramine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
clomipramine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - clonidine
nortriptyline decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.
- cyclobenzaprine
nortriptyline and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.
- dacomitinib
dacomitinib will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.
- desipramine
desipramine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
desipramine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - desvenlafaxine
nortriptyline and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.
- dexfenfluramine
nortriptyline, dexfenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dexmethylphenidate
nortriptyline, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dextroamphetamine
nortriptyline, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dextromethorphan
nortriptyline and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.
- diethylpropion
nortriptyline, diethylpropion. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dobutamine
nortriptyline, dobutamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dofetilide
nortriptyline and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.
dofetilide increases toxicity of nortriptyline by QTc interval. Avoid or Use Alternate Drug. - dolasetron
dolasetron, nortriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- dopamine
nortriptyline, dopamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dopexamine
nortriptyline, dopexamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- doxepin
doxepin and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
doxepin and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - dronedarone
nortriptyline and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.
- droperidol
nortriptyline and droperidol both increase QTc interval. Avoid or Use Alternate Drug.
- duloxetine
duloxetine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.
- encorafenib
encorafenib and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- ephedrine
nortriptyline, ephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- epinephrine
epinephrine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
nortriptyline, epinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - epinephrine racemic
epinephrine racemic and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
nortriptyline, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - erythromycin base
nortriptyline and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
nortriptyline and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin lactobionate
nortriptyline and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin stearate
nortriptyline and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.
- escitalopram
escitalopram and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.
- fenfluramine
nortriptyline, fenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- fexinidazole
fexinidazole and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- fluconazole
nortriptyline and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- fluoxetine
fluoxetine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
fluoxetine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - fluphenazine
fluphenazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- fluvoxamine
fluvoxamine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.
- formoterol
nortriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
nortriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - fosamprenavir
fosamprenavir increases levels of nortriptyline by decreasing metabolism. Avoid or Use Alternate Drug.
- givosiran
givosiran will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.
- granisetron
granisetron, nortriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- guanfacine
nortriptyline decreases effects of guanfacine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.
- haloperidol
haloperidol will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
nortriptyline and haloperidol both increase QTc interval. Avoid or Use Alternate Drug. - hydroxychloroquine sulfate
hydroxychloroquine sulfate and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- imipramine
imipramine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
imipramine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - iobenguane I 131
nortriptyline will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.
- isoproterenol
nortriptyline, isoproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- itraconazole
nortriptyline and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
- ivosidenib
ivosidenib and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
- ketoconazole
nortriptyline and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
- lefamulin
lefamulin and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- levalbuterol
nortriptyline, levalbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- levoketoconazole
nortriptyline and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
- levomilnacipran
levomilnacipran and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.
- linezolid
linezolid and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.
- lisdexamfetamine
nortriptyline, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- lofepramine
lofepramine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
lofepramine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - lorcaserin
nortriptyline and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.
- lumefantrine
lumefantrine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
nortriptyline and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. - macimorelin
macimorelin and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.
- maprotiline
maprotiline and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
maprotiline and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - mefloquine
mefloquine increases toxicity of nortriptyline by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.
- meperidine
nortriptyline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- metaproterenol
nortriptyline, metaproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- methamphetamine
nortriptyline, methamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- methylene blue
methylene blue and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.
- methylenedioxymethamphetamine
nortriptyline, methylenedioxymethamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- metoclopramide intranasal
nortriptyline, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- midodrine
nortriptyline, midodrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- milnacipran
milnacipran and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.
- mirtazapine
mirtazapine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- mobocertinib
mobocertinib and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.
- moxifloxacin
nortriptyline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- nefazodone
nefazodone and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.
- netupitant/palonosetron
netupitant/palonosetron, nortriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- nilotinib
nortriptyline and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
- norepinephrine
nortriptyline, norepinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- octreotide
nortriptyline and octreotide both increase QTc interval. Avoid or Use Alternate Drug.
- octreotide (Antidote)
nortriptyline and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.
- olopatadine intranasal
nortriptyline and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- ondansetron
nortriptyline and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.
ondansetron, nortriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. - ozanimod
ozanimod increases toxicity of nortriptyline by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.
- palonosetron
palonosetron, nortriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- paroxetine
paroxetine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
paroxetine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - perphenazine
perphenazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- phendimetrazine
nortriptyline, phendimetrazine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- phentermine
nortriptyline, phentermine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- phenylephrine
nortriptyline, phenylephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- phenylephrine PO
nortriptyline, phenylephrine PO. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- pirbuterol
nortriptyline, pirbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- pitolisant
nortriptyline decreases effects of pitolisant by Other (see comment). Avoid or Use Alternate Drug. Comment: Pitolisant increases histamine levels in the brain; therefore, H1 receptor antagonists that cross the blood-brain barrier may reduce the efficacy of pitolisant.
- promazine
promazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- propylhexedrine
nortriptyline, propylhexedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- protriptyline
nortriptyline and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.
nortriptyline and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - pseudoephedrine
nortriptyline increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- quinidine
quinidine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
- rasagiline
rasagiline and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia has been reported with the combined treatment of an antidepressant and rasagiline. Avoid combination within 14 days of MAOI use.
- ribociclib
ribociclib will increase the level or effect of nortriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
ribociclib increases toxicity of nortriptyline by QTc interval. Avoid or Use Alternate Drug. - salmeterol
nortriptyline, salmeterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- selegiline transdermal
selegiline transdermal and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.
- selinexor
selinexor, nortriptyline. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
- serdexmethylphenidate/dexmethylphenidate
nortriptyline, serdexmethylphenidate/dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- sertraline
sertraline and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.
sertraline and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. - sodium oxybate
nortriptyline, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- St John's Wort
nortriptyline and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.
- tedizolid
tedizolid, nortriptyline. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.
- terbutaline
nortriptyline, terbutaline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- thioridazine
thioridazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- toremifene
nortriptyline and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.
- trazodone
nortriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
trazodone and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - trifluoperazine
trifluoperazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.
- trimipramine
nortriptyline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
nortriptyline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - umeclidinium bromide/vilanterol inhaled
nortriptyline increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
nortriptyline and umeclidinium bromide/vilanterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiated - vandetanib
nortriptyline, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.
- vemurafenib
vemurafenib and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.
- venlafaxine
venlafaxine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
venlafaxine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. - vilanterol/fluticasone furoate inhaled
nortriptyline and vilanterol/fluticasone furoate inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiated
nortriptyline increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated. - vilazodone
nortriptyline, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .
- vortioxetine
nortriptyline, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.
- xylometazoline
nortriptyline, xylometazoline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- yohimbe
yohimbe, nortriptyline. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.
- yohimbine
nortriptyline, yohimbine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- ziprasidone
nortriptyline and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.
Monitor Closely (365)
- 5-HTP
nortriptyline and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.
- abiraterone
abiraterone increases levels of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.
- abobotulinumtoxinA
abobotulinumtoxinA increases effects of nortriptyline by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .
- aclidinium
aclidinium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- acrivastine
acrivastine and nortriptyline both increase sedation. Use Caution/Monitor.
- albuterol
nortriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and nortriptyline both increase QTc interval. Use Caution/Monitor. - alfentanil
alfentanil and nortriptyline both increase sedation. Use Caution/Monitor.
- alfuzosin
nortriptyline and alfuzosin both increase QTc interval. Use Caution/Monitor.
alfuzosin and nortriptyline both increase QTc interval. Use Caution/Monitor. - almotriptan
almotriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.
- alprazolam
alprazolam and nortriptyline both increase sedation. Use Caution/Monitor.
- amifampridine
nortriptyline increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.
- amiodarone
amiodarone will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- amisulpride
nortriptyline and amisulpride both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.
amisulpride and nortriptyline both increase sedation. Use Caution/Monitor. - amitriptyline
amitriptyline and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
amitriptyline and nortriptyline both increase sedation. Use Caution/Monitor. - amobarbital
amobarbital and nortriptyline both increase sedation. Use Caution/Monitor.
- amoxapine
amoxapine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
amoxapine and nortriptyline both increase sedation. Use Caution/Monitor. - anagrelide
anagrelide and nortriptyline both increase QTc interval. Use Caution/Monitor.
- anticholinergic/sedative combos
anticholinergic/sedative combos and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- apomorphine
nortriptyline and apomorphine both increase sedation. Use Caution/Monitor.
apomorphine and nortriptyline both increase QTc interval. Use Caution/Monitor. - arformoterol
nortriptyline increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
arformoterol and nortriptyline both increase QTc interval. Use Caution/Monitor. - aripiprazole
aripiprazole and nortriptyline both increase sedation. Use Caution/Monitor.
aripiprazole and nortriptyline both increase QTc interval. Use Caution/Monitor. - armodafinil
nortriptyline increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- asenapine
asenapine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
asenapine and nortriptyline both increase QTc interval. Use Caution/Monitor.
asenapine and nortriptyline both increase sedation. Use Caution/Monitor. - asenapine transdermal
asenapine transdermal and nortriptyline both increase QTc interval. Use Caution/Monitor.
asenapine transdermal and nortriptyline both increase sedation. Use Caution/Monitor. - atazanavir
atazanavir increases levels of nortriptyline by unspecified interaction mechanism. Use Caution/Monitor.
- atomoxetine
atomoxetine and nortriptyline both increase QTc interval. Use Caution/Monitor.
- atracurium
atracurium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine
atropine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine IV/IM
atropine IV/IM and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- avapritinib
avapritinib and nortriptyline both increase sedation. Use Caution/Monitor.
- azelastine
azelastine and nortriptyline both increase sedation. Use Caution/Monitor.
- azithromycin
nortriptyline and azithromycin both increase QTc interval. Use Caution/Monitor.
- baclofen
baclofen and nortriptyline both increase sedation. Use Caution/Monitor.
- bedaquiline
nortriptyline and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely
- belladonna alkaloids
belladonna alkaloids and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna and opium
belladonna and opium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and nortriptyline both increase sedation. Use Caution/Monitor. - benperidol
benperidol and nortriptyline both increase sedation. Use Caution/Monitor.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, nortriptyline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.
- benzphetamine
nortriptyline increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- benztropine
benztropine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.
- bethanechol
bethanechol increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- brexpiprazole
brexpiprazole and nortriptyline both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and nortriptyline both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and nortriptyline both increase sedation. Use Caution/Monitor.
- brompheniramine
brompheniramine and nortriptyline both increase sedation. Use Caution/Monitor.
- buprenorphine
buprenorphine and nortriptyline both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal and nortriptyline both increase sedation. Use Caution/Monitor.
- buprenorphine subdermal implant
nortriptyline, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.
- buprenorphine, long-acting injection
nortriptyline, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.
- bupropion
bupropion will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
nortriptyline increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible. - butabarbital
butabarbital and nortriptyline both increase sedation. Use Caution/Monitor.
- butalbital
butalbital and nortriptyline both increase sedation. Use Caution/Monitor.
- butorphanol
butorphanol and nortriptyline both increase sedation. Use Caution/Monitor.
- caffeine
nortriptyline increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbachol
carbachol increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbinoxamine
carbinoxamine and nortriptyline both increase sedation. Use Caution/Monitor.
- carisoprodol
carisoprodol and nortriptyline both increase sedation. Use Caution/Monitor.
- celecoxib
celecoxib will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- cenobamate
cenobamate, nortriptyline. Either increases effects of the other by sedation. Use Caution/Monitor.
- ceritinib
ceritinib and nortriptyline both increase QTc interval. Use Caution/Monitor.
- cevimeline
cevimeline increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chloral hydrate
chloral hydrate and nortriptyline both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide and nortriptyline both increase sedation. Use Caution/Monitor.
- chloroquine
chloroquine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
chloroquine increases toxicity of nortriptyline by QTc interval. Use Caution/Monitor. - chlorpheniramine
chlorpheniramine and nortriptyline both increase sedation. Use Caution/Monitor.
- chlorpromazine
chlorpromazine and nortriptyline both increase sedation. Use Caution/Monitor.
- chlorzoxazone
chlorzoxazone and nortriptyline both increase sedation. Use Caution/Monitor.
- cimetidine
cimetidine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- cinnarizine
cinnarizine and nortriptyline both increase sedation. Use Caution/Monitor.
- cisatracurium
cisatracurium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clemastine
clemastine and nortriptyline both increase sedation. Use Caution/Monitor.
- clobazam
clobazam will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly.
nortriptyline, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression). - clomipramine
clomipramine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
clomipramine and nortriptyline both increase sedation. Use Caution/Monitor. - clonazepam
clonazepam and nortriptyline both increase sedation. Use Caution/Monitor.
- clorazepate
clorazepate and nortriptyline both increase sedation. Use Caution/Monitor.
- clozapine
clozapine and nortriptyline both increase sedation. Use Caution/Monitor.
clozapine and nortriptyline both increase QTc interval. Use Caution/Monitor. - cobicistat
cobicistat will increase the level or effect of nortriptyline by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with TCAs and cobicistat.
- cocaine topical
nortriptyline and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.
- codeine
codeine and nortriptyline both increase sedation. Use Caution/Monitor.
- crizotinib
crizotinib and nortriptyline both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- cyclizine
cyclizine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
cyclizine and nortriptyline both increase sedation. Use Caution/Monitor. - cyclobenzaprine
cyclobenzaprine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
cyclobenzaprine and nortriptyline both increase sedation. Use Caution/Monitor. - cyclosporine
cyclosporine will increase the level or effect of nortriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cyproheptadine
cyproheptadine and nortriptyline both increase sedation. Use Caution/Monitor.
- dantrolene
dantrolene and nortriptyline both increase sedation. Use Caution/Monitor.
- daridorexant
nortriptyline and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- darifenacin
darifenacin will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
darifenacin and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. - dasatinib
nortriptyline and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- debrisoquine
nortriptyline decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.
- degarelix
degarelix and nortriptyline both increase QTc interval. Use Caution/Monitor.
- desflurane
desflurane and nortriptyline both increase sedation. Use Caution/Monitor.
desflurane and nortriptyline both increase QTc interval. Use Caution/Monitor. - desipramine
desipramine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
desipramine and nortriptyline both increase sedation. Use Caution/Monitor. - desvenlafaxine
desvenlafaxine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mg
- deutetrabenazine
nortriptyline and deutetrabenazine both increase sedation. Use Caution/Monitor.
deutetrabenazine and nortriptyline both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation). - dexchlorpheniramine
dexchlorpheniramine and nortriptyline both increase sedation. Use Caution/Monitor.
- dexfenfluramine
nortriptyline increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nortriptyline and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely. - dexmedetomidine
dexmedetomidine and nortriptyline both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
nortriptyline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
nortriptyline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nortriptyline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.
nortriptyline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor. - dextroamphetamine transdermal
nortriptyline will increase the level or effect of dextroamphetamine transdermal by pharmacodynamic synergism. Modify Therapy/Monitor Closely. May enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in dextroamphetamine levels in brain; May be potentiate cardiovascular effects. Monitor frequently and adjust or use an alternant based on clinical response.
- dextromoramide
dextromoramide and nortriptyline both increase sedation. Use Caution/Monitor.
- diamorphine
diamorphine and nortriptyline both increase sedation. Use Caution/Monitor.
- diazepam
diazepam and nortriptyline both increase sedation. Use Caution/Monitor.
- diazepam intranasal
diazepam intranasal, nortriptyline. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.
- dicyclomine
dicyclomine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- diethylpropion
nortriptyline increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and nortriptyline both increase sedation. Use Caution/Monitor.
- difenoxin hcl
difenoxin hcl and nortriptyline both increase sedation. Use Caution/Monitor.
- dihydroergotamine
nortriptyline and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.
- dihydroergotamine intranasal
nortriptyline and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.
- dimenhydrinate
dimenhydrinate and nortriptyline both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
diphenhydramine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
diphenhydramine and nortriptyline both increase sedation. Use Caution/Monitor. - diphenoxylate hcl
diphenoxylate hcl and nortriptyline both increase sedation. Use Caution/Monitor.
- dipipanone
dipipanone and nortriptyline both increase sedation. Use Caution/Monitor.
- dobutamine
nortriptyline increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dolasetron
nortriptyline and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- donepezil
donepezil increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
donepezil and nortriptyline both increase QTc interval. Use Caution/Monitor. - dopamine
nortriptyline increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
nortriptyline increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- doxepin
doxepin and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
doxepin and nortriptyline both increase sedation. Use Caution/Monitor. - doxylamine
doxylamine and nortriptyline both increase sedation. Use Caution/Monitor.
- droperidol
droperidol and nortriptyline both increase sedation. Use Caution/Monitor.
- duloxetine
duloxetine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- echothiophate iodide
echothiophate iodide increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- efavirenz
efavirenz and nortriptyline both increase QTc interval. Use Caution/Monitor.
- eletriptan
eletriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.
- eliglustat
eliglustat increases levels of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.
eliglustat and nortriptyline both increase QTc interval. Use Caution/Monitor. - entrectinib
entrectinib and nortriptyline both increase QTc interval. Use Caution/Monitor.
- ephedrine
nortriptyline increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nortriptyline increases effects of ephedrine by unknown mechanism. Use Caution/Monitor. - epinephrine
nortriptyline increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nortriptyline increases effects of epinephrine by unknown mechanism. Use Caution/Monitor. - epinephrine inhaled
nortriptyline and epinephrine inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Tricyclic antidepressants may potentiate epinephrine effect on cardiovascular system.
- epinephrine racemic
nortriptyline increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nortriptyline increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor. - ergotamine
nortriptyline and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.
- eribulin
eribulin and nortriptyline both increase QTc interval. Use Caution/Monitor.
- escitalopram
escitalopram increases toxicity of nortriptyline by QTc interval. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, nortriptyline. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- estazolam
estazolam and nortriptyline both increase sedation. Use Caution/Monitor.
- ethanol
nortriptyline and ethanol both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and nortriptyline both increase sedation. Use Caution/Monitor.
- ezogabine
ezogabine, nortriptyline. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.
- fedratinib
fedratinib will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.
- fenfluramine
nortriptyline increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nortriptyline and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.
fenfluramine, nortriptyline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome. - fesoterodine
fesoterodine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- fingolimod
fingolimod and nortriptyline both increase QTc interval. Use Caution/Monitor.
- flavoxate
flavoxate and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- flecainide
nortriptyline and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.
- fluoxetine
nortriptyline and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.
- fluphenazine
fluphenazine and nortriptyline both increase sedation. Use Caution/Monitor.
- flurazepam
flurazepam and nortriptyline both increase sedation. Use Caution/Monitor.
- fluvoxamine
fluvoxamine and nortriptyline both increase QTc interval. Modify Therapy/Monitor Closely.
- formoterol
nortriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- foscarnet
nortriptyline and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.
- fostemsavir
nortriptyline and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- frovatriptan
frovatriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.
- gabapentin
gabapentin, nortriptyline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- gabapentin enacarbil
gabapentin enacarbil, nortriptyline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- galantamine
galantamine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ganaxolone
nortriptyline and ganaxolone both increase sedation. Use Caution/Monitor.
- gemifloxacin
gemifloxacin and nortriptyline both increase QTc interval. Use Caution/Monitor.
- gilteritinib
gilteritinib and nortriptyline both increase QTc interval. Use Caution/Monitor.
- glycopyrrolate
glycopyrrolate and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
nortriptyline increases levels of glycopyrrolate by unknown mechanism. Use Caution/Monitor. - glycopyrrolate inhaled
glycopyrrolate inhaled and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
nortriptyline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor. - glycopyrronium tosylate topical
glycopyrronium tosylate topical, nortriptyline. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.
- granisetron
granisetron and nortriptyline both increase QTc interval. Use Caution/Monitor.
- haloperidol
haloperidol and nortriptyline both increase sedation. Use Caution/Monitor.
- henbane
henbane and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- homatropine
homatropine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- huperzine A
huperzine A increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydrocodone
hydrocodone, nortriptyline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.
- hydromorphone
hydromorphone and nortriptyline both increase sedation. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and nortriptyline both increase sedation. Use Caution/Monitor.
hydroxyzine and nortriptyline both increase QTc interval. Use Caution/Monitor. - hyoscyamine
hyoscyamine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine spray
hyoscyamine spray and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- iloperidone
nortriptyline and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.
iloperidone and nortriptyline both increase sedation. Use Caution/Monitor. - imatinib
imatinib will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- imipramine
imipramine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
imipramine and nortriptyline both increase sedation. Use Caution/Monitor. - indacaterol, inhaled
indacaterol, inhaled, nortriptyline. QTc interval. Use Caution/Monitor. Indacaterol should be administered with extreme caution to patients treated with TCAs. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.
- ipratropium
ipratropium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.
- isoflurane
isoflurane and nortriptyline both increase QTc interval. Use Caution/Monitor.
- isoniazid
nortriptyline and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely.
- isoproterenol
nortriptyline increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- itraconazole
itraconazole and nortriptyline both increase QTc interval. Use Caution/Monitor.
- ketamine
ketamine and nortriptyline both increase sedation. Use Caution/Monitor.
- ketotifen, ophthalmic
nortriptyline and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- L-tryptophan
nortriptyline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
- lapatinib
nortriptyline and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- lasmiditan
lasmiditan, nortriptyline. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
nortriptyline increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome. - lemborexant
lemborexant, nortriptyline. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- levalbuterol
nortriptyline increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levofloxacin
nortriptyline and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
- levoketoconazole
levoketoconazole will increase the level or effect of nortriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- levorphanol
levorphanol and nortriptyline both increase sedation. Use Caution/Monitor.
- levothyroxine
levothyroxine increases effects of nortriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.
- liothyronine
liothyronine increases effects of nortriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.
- liotrix
liotrix increases effects of nortriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.
- lisdexamfetamine
nortriptyline increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nortriptyline, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s). - lithium
nortriptyline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.
lithium and nortriptyline both increase QTc interval. Use Caution/Monitor. - lofepramine
lofepramine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
lofepramine and nortriptyline both increase sedation. Use Caution/Monitor. - lofexidine
nortriptyline and lofexidine both increase sedation. Use Caution/Monitor.
nortriptyline decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor. - loprazolam
loprazolam and nortriptyline both increase sedation. Use Caution/Monitor.
- lorazepam
lorazepam and nortriptyline both increase sedation. Use Caution/Monitor.
- lorcaserin
lorcaserin will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- lormetazepam
lormetazepam and nortriptyline both increase sedation. Use Caution/Monitor.
- loxapine
loxapine and nortriptyline both increase sedation. Use Caution/Monitor.
- loxapine inhaled
loxapine inhaled and nortriptyline both increase sedation. Use Caution/Monitor.
- lsd
nortriptyline and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.
- lurasidone
lurasidone increases effects of nortriptyline by Other (see comment). Use Caution/Monitor. Comment: Potential for additive CNS effects .
- maprotiline
maprotiline and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
maprotiline and nortriptyline both increase sedation. Use Caution/Monitor. - maraviroc
maraviroc will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- marijuana
marijuana will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
nortriptyline and marijuana both increase sedation. Use Caution/Monitor. - meclizine
meclizine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- melatonin
nortriptyline and melatonin both increase sedation. Use Caution/Monitor.
- meperidine
meperidine and nortriptyline both increase sedation. Use Caution/Monitor.
- meprobamate
nortriptyline and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
nortriptyline increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
metaxalone and nortriptyline both increase sedation. Use Caution/Monitor.
- methadone
nortriptyline and methadone both increase QTc interval. Modify Therapy/Monitor Closely.
methadone and nortriptyline both increase sedation. Use Caution/Monitor. - methamphetamine
nortriptyline increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
methocarbamol and nortriptyline both increase sedation. Use Caution/Monitor.
- methscopolamine
methscopolamine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methylenedioxymethamphetamine
nortriptyline increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methylphenidate
nortriptyline, methylphenidate. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- methylphenidate transdermal
methylphenidate transdermal will increase the level or effect of nortriptyline by decreasing elimination. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate.
- midazolam
midazolam and nortriptyline both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, nortriptyline. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- midodrine
nortriptyline increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mifepristone
mifepristone, nortriptyline. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.
- mirabegron
mirabegron will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- mirtazapine
nortriptyline and mirtazapine both increase sedation. Use Caution/Monitor.
nortriptyline and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. - modafinil
nortriptyline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- morphine
morphine and nortriptyline both increase sedation. Use Caution/Monitor.
nortriptyline and morphine both increase serotonin levels. Modify Therapy/Monitor Closely. - motherwort
nortriptyline and motherwort both increase sedation. Use Caution/Monitor.
- moxonidine
nortriptyline and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
nortriptyline and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
nalbuphine and nortriptyline both increase sedation. Use Caution/Monitor.
- naratriptan
naratriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.
- nefopam
nefopam, nortriptyline. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.
- neostigmine
neostigmine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nilotinib
nilotinib will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- norepinephrine
nortriptyline increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
nortriptyline increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor. - ofloxacin
nortriptyline and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
- olanzapine
olanzapine and nortriptyline both increase sedation. Use Caution/Monitor.
olanzapine and nortriptyline both increase QTc interval. Use Caution/Monitor. - oliceridine
nortriptyline, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.
nortriptyline increases toxicity of oliceridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics. - olodaterol inhaled
nortriptyline and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias
- onabotulinumtoxinA
onabotulinumtoxinA and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- opium tincture
opium tincture and nortriptyline both increase sedation. Use Caution/Monitor.
- orphenadrine
nortriptyline and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
orphenadrine and nortriptyline both increase sedation. Use Caution/Monitor. - osilodrostat
osilodrostat and nortriptyline both increase QTc interval. Use Caution/Monitor.
- osimertinib
osimertinib and nortriptyline both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.
- oxazepam
oxazepam and nortriptyline both increase sedation. Use Caution/Monitor.
- oxybutynin
oxybutynin and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin topical
oxybutynin topical and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin transdermal
oxybutynin transdermal and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxycodone
oxycodone and nortriptyline both increase sedation. Use Caution/Monitor.
- oxymetazoline intranasal
nortriptyline increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.
- oxymorphone
oxymorphone and nortriptyline both increase sedation. Use Caution/Monitor.
- ozanimod
ozanimod and nortriptyline both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.
- paliperidone
nortriptyline and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.
paliperidone and nortriptyline both increase sedation. Use Caution/Monitor. - pancuronium
pancuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- papaveretum
papaveretum and nortriptyline both increase sedation. Use Caution/Monitor.
- papaverine
nortriptyline and papaverine both increase sedation. Use Caution/Monitor.
- parecoxib
parecoxib will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- paroxetine
nortriptyline and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.
- pasireotide
nortriptyline and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.
- pazopanib
nortriptyline and pazopanib both increase QTc interval. Use Caution/Monitor.
- peginterferon alfa 2b
peginterferon alfa 2b, nortriptyline. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.
- pentazocine
pentazocine and nortriptyline both increase sedation. Use Caution/Monitor.
nortriptyline and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely. - pentobarbital
pentobarbital and nortriptyline both increase sedation. Use Caution/Monitor.
- perphenazine
perphenazine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
perphenazine and nortriptyline both increase sedation. Use Caution/Monitor. - phendimetrazine
nortriptyline increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenobarbital
phenobarbital and nortriptyline both increase sedation. Use Caution/Monitor.
- phentermine
nortriptyline increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
nortriptyline increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine ophthalmic
nortriptyline, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- phenylephrine PO
nortriptyline increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
nortriptyline and pholcodine both increase sedation. Use Caution/Monitor.
- physostigmine
physostigmine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pilocarpine
pilocarpine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimozide
pimozide and nortriptyline both increase sedation. Use Caution/Monitor.
- pirbuterol
nortriptyline increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- posaconazole
nortriptyline and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- pralidoxime
pralidoxime and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- pregabalin
pregabalin, nortriptyline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- primidone
primidone and nortriptyline both increase sedation. Use Caution/Monitor.
- prochlorperazine
prochlorperazine and nortriptyline both increase QTc interval. Use Caution/Monitor.
prochlorperazine and nortriptyline both increase sedation. Use Caution/Monitor. - promethazine
promethazine and nortriptyline both increase QTc interval. Use Caution/Monitor.
promethazine and nortriptyline both increase sedation. Use Caution/Monitor. - propafenone
propafenone will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- propantheline
propantheline and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- propofol
propofol and nortriptyline both increase sedation. Use Caution/Monitor.
- propylhexedrine
nortriptyline increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
nortriptyline and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
nortriptyline and protriptyline both increase sedation. Use Caution/Monitor. - pyridostigmine
pyridostigmine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quazepam
quazepam and nortriptyline both increase sedation. Use Caution/Monitor.
- quetiapine
quetiapine and nortriptyline both increase sedation. Use Caution/Monitor.
quetiapine, nortriptyline. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT. - quinacrine
quinacrine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- quinine
nortriptyline and quinine both increase QTc interval. Use Caution/Monitor.
- quizartinib
quizartinib, nortriptyline. Either increases effects of the other by QTc interval. Modify Therapy/Monitor Closely. Monitor patients more frequently with ECG if coadministered with QT prolonging drugs.
- ramelteon
nortriptyline and ramelteon both increase sedation. Use Caution/Monitor.
- ranolazine
ranolazine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
nortriptyline and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely. - rapacuronium
rapacuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- remimazolam
remimazolam, nortriptyline. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.
- rifabutin
rifabutin decreases levels of nortriptyline by increasing metabolism. Use Caution/Monitor.
- rilpivirine
rilpivirine increases toxicity of nortriptyline by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.
- risperidone
nortriptyline and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and nortriptyline both increase sedation. Use Caution/Monitor. - ritonavir
ritonavir will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- rizatriptan
rizatriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.
- rocuronium
rocuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- romidepsin
nortriptyline and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.
- salmeterol
nortriptyline increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- SAMe
nortriptyline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.
- scopolamine
scopolamine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- scullcap
nortriptyline and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
secobarbital and nortriptyline both increase sedation. Use Caution/Monitor.
- selpercatinib
selpercatinib increases toxicity of nortriptyline by QTc interval. Use Caution/Monitor.
- sertraline
sertraline will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely.
- sevoflurane
sevoflurane and nortriptyline both increase sedation. Use Caution/Monitor.
sevoflurane and nortriptyline both increase QTc interval. Use Caution/Monitor. - shepherd's purse
nortriptyline and shepherd's purse both increase sedation. Use Caution/Monitor.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of nortriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
nortriptyline, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases effects of nortriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- solifenacin
solifenacin and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
solifenacin and nortriptyline both increase QTc interval. Use Caution/Monitor. - sorafenib
sorafenib and nortriptyline both increase QTc interval. Use Caution/Monitor.
- stiripentol
stiripentol, nortriptyline. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
- succinylcholine
succinylcholine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sufentanil
sufentanil and nortriptyline both increase sedation. Use Caution/Monitor.
- sufentanil SL
sufentanil SL, nortriptyline. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.
- sulfamethoxazole
nortriptyline and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.
- sumatriptan
sumatriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.
- sumatriptan intranasal
sumatriptan intranasal and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.
- suvorexant
suvorexant and nortriptyline both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary
- tacrolimus
tacrolimus and nortriptyline both increase QTc interval. Use Caution/Monitor.
- tapentadol
tapentadol and nortriptyline both increase sedation. Use Caution/Monitor.
nortriptyline and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely. - telavancin
nortriptyline and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.
- temazepam
temazepam and nortriptyline both increase sedation. Use Caution/Monitor.
- terbutaline
nortriptyline increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tetrabenazine
tetrabenazine and nortriptyline both increase QTc interval. Use Caution/Monitor.
- thioridazine
thioridazine and nortriptyline both increase sedation. Use Caution/Monitor.
- thiothixene
thiothixene and nortriptyline both increase sedation. Use Caution/Monitor.
- thyroid desiccated
thyroid desiccated increases effects of nortriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.
- tiotropium
tiotropium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- tipranavir
tipranavir will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- tolterodine
tolterodine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- topiramate
nortriptyline and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
tramadol and nortriptyline both increase sedation. Use Caution/Monitor.
nortriptyline and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely. - trazodone
nortriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
nortriptyline and trazodone both increase sedation. Use Caution/Monitor. - triazolam
triazolam and nortriptyline both increase sedation. Use Caution/Monitor.
- triclofos
triclofos and nortriptyline both increase sedation. Use Caution/Monitor.
- trifluoperazine
trifluoperazine and nortriptyline both increase sedation. Use Caution/Monitor.
- trihexyphenidyl
trihexyphenidyl and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.
- trimethoprim
nortriptyline and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.
- trimipramine
nortriptyline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
nortriptyline and trimipramine both increase sedation. Use Caution/Monitor. - triprolidine
triprolidine and nortriptyline both increase sedation. Use Caution/Monitor.
- tropisetron
nortriptyline and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.
- trospium chloride
trospium chloride and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- valbenazine
valbenazine and nortriptyline both increase QTc interval. Use Caution/Monitor.
- valerian
valerian and nortriptyline both increase sedation. Use Caution/Monitor.
- vecuronium
vecuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- venlafaxine
nortriptyline and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.
- voclosporin
voclosporin, nortriptyline. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- voriconazole
nortriptyline and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- xylometazoline
nortriptyline increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
nortriptyline increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
nortriptyline and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
ziprasidone and nortriptyline both increase sedation. Use Caution/Monitor.
- zolmitriptan
zolmitriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.
Minor (71)
- acarbose
nortriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- amobarbital
amobarbital, nortriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- atropine
nortriptyline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- atropine IV/IM
nortriptyline increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.
- bazedoxifene/conjugated estrogens
bazedoxifene/conjugated estrogens, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- brimonidine
nortriptyline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.
- butabarbital
butabarbital, nortriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- butalbital
butalbital, nortriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- carbamazepine
carbamazepine decreases levels of nortriptyline by increasing metabolism. Minor/Significance Unknown.
- chlorpromazine
nortriptyline, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
nortriptyline, chlorpromazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - chlorpropamide
nortriptyline increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.
- conjugated estrogens
conjugated estrogens, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- conjugated estrogens, vaginal
conjugated estrogens, vaginal, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- desflurane
desflurane, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- dexmethylphenidate
dexmethylphenidate increases effects of nortriptyline by decreasing metabolism. Minor/Significance Unknown.
- estradiol
estradiol, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- estrogens conjugated synthetic
estrogens conjugated synthetic, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- estrogens esterified
estrogens esterified, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens may inhibit hepatic metabolism of tricyclic antidepressants. However, interactions are not common.
- estropipate
estropipate, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- ethinylestradiol
ethinylestradiol, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Oxidative metabolism of TCAs may be decreased by ethinyl estradiol. Increased antidepressant serum concentrations may occur. Potential for increased TCA adverse effects.
- etomidate
etomidate, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- eucalyptus
nortriptyline and eucalyptus both increase sedation. Minor/Significance Unknown.
- fluphenazine
nortriptyline, fluphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
nortriptyline, fluphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - glimepiride
nortriptyline increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.
- glipizide
nortriptyline increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.
- glyburide
nortriptyline increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.
- hydroxyprogesterone caproate (DSC)
hydroxyprogesterone caproate (DSC), nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- insulin aspart
nortriptyline increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin detemir
nortriptyline increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin glargine
nortriptyline increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin glulisine
nortriptyline increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin lispro
nortriptyline increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin NPH
nortriptyline increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin regular human
nortriptyline increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.
- isoproterenol
isoproterenol, nortriptyline. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.
- ketamine
ketamine, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- lithium
lithium, nortriptyline. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.
- mestranol
mestranol, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- metformin
nortriptyline increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.
- miglitol
nortriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.
- nateglinide
nortriptyline increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.
- panax ginseng
panax ginseng increases effects of nortriptyline by pharmacodynamic synergism. Minor/Significance Unknown.
- pentobarbital
pentobarbital, nortriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- perphenazine
nortriptyline, perphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
nortriptyline, perphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - phenobarbital
phenobarbital, nortriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- pioglitazone
nortriptyline increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.
- pleurisy root
pleurisy root decreases effects of nortriptyline by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.
- primidone
primidone, nortriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- prochlorperazine
nortriptyline, prochlorperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
nortriptyline, prochlorperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - progesterone micronized
progesterone micronized, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- promazine
nortriptyline, promazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
nortriptyline, promazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - promethazine
nortriptyline, promethazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
nortriptyline, promethazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - propofol
propofol, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- repaglinide
nortriptyline increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.
- rifampin
rifampin decreases levels of nortriptyline by increasing metabolism. Minor/Significance Unknown.
- rosiglitazone
nortriptyline increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.
- sage
nortriptyline and sage both increase sedation. Minor/Significance Unknown.
- saxagliptin
nortriptyline increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
- secobarbital
secobarbital, nortriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- serdexmethylphenidate/dexmethylphenidate
serdexmethylphenidate/dexmethylphenidate increases effects of nortriptyline by decreasing metabolism. Minor/Significance Unknown.
- sevoflurane
sevoflurane, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- sitagliptin
nortriptyline increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
- sulfamethoxazole
sulfamethoxazole decreases levels of nortriptyline by unspecified interaction mechanism. Minor/Significance Unknown.
- thioridazine
nortriptyline, thioridazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
nortriptyline, thioridazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - tolazamide
nortriptyline increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- tolbutamide
nortriptyline increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.
- trifluoperazine
nortriptyline, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
nortriptyline, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - vasopressin
nortriptyline increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- verapamil
verapamil increases levels of nortriptyline by decreasing metabolism. Minor/Significance Unknown.
- vildagliptin
nortriptyline increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
- zolpidem
zolpidem, nortriptyline. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.
Adverse Effects
Frequency Not Defined
Fatigue
Lethargy
Sedation
Weakness
Dry mouth
Constipation
Blurred vision
Agitation
Anxiety
Headache
Insomnia
Nausea
Vomiting
Sweating
Orthostatic hypotension, ECG changes, tachycardia
Confusion, extrapyramidal symptoms, dizziness, paresthesia, tinnitus
Rash
Increased LFTs
Sexual dysfunction
Seizure
Agranulocytosis
Eosinophilia
Leukopenia
Thrombocytopenia
SIADH
Postmarketing
Brugada syndrome
Warnings
Black Box Warnings
In short-term studies, antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 years) taking antidepressants for major depressive disorders or other psychiatric illnesses
This increase was not seen in patients aged over age 24 years; a slight decrease in suicidal thinking was seen in adults over age 65 years
In children and young adults, risks must be weighed against the benefits of taking antidepressants
Patients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies; this should be done during the initial 1-2 months of therapy and dosage adjustments
The patient’s family should communicate any abrupt changes in behavior to the healthcare provider
Worsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapy
This drug is not approved for use in pediatric patients
Contraindications
Hypersensitivity
Any drugs or conditions that prolong QT interval
Acute recovery post-MI
Coadministration with serotonergic drugs
- Concomitant with or within 14 days of MAOIs (serotonin syndrome)
- Starting nortriptyline in a patient who is being treated with linezolid or IV methylene blue is contraindicated because of an increased risk of serotonin syndrome
- If linezolid or IV methylene blue must be administered, discontinue nortriptyline immediately and monitor for CNS toxicity; may resume nortriptyline 24 hours after last linezolid or methylene blue dose or after 2 weeks of monitoring, whichever comes first
Cautions
Use cautioni in patients with BPH, urinary/GI retention, hyperthyroidism, seizure disorder, brain tumor, respiratory impairment, bipolar/mania (may worsen psychosis)
Clinical worsening and suicidal ideation may occur despite medication in adolescents and young adults (18-24 years)
Potentially life-threatening serotonin syndrome reported when coadministered with drugs that impair serotonin metabolism (in particular, MAOIs, including nonpsychiatric MAOIs, such as linezolid and IV methylene blue)
Risk of anticholinergic side effects
May cause bone marrow suppression (rare)
May cause orthostatic hypotension
May cause sedation, which may impair physical or mental abilities; use caution when performing tasks that require mental alertness (eg, operating heavy machinery)
Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy
May cause sedation and impair physical or mental abilities
Withdraw gradually
Bone fractures have been associated with antidepressant treatment; consider possibility of bone fractures in patients if antidepressant treated patient presents with unexplained bone pain, swelling, bruising or point tenderness
Use with caution in patients who would not tolerate frequent hypotensive episodes, including patients with cardiovascular disease, hypovolemia or with concurrent medication that predisposes for hypotension/bradycardia
Use caution in patients with cardiovascular disease, diabetes mellitus (may alter glucose regulation), hepatic/renal impairment, and the elderly
Abrupt discontinuation or interruption of antidepressant therapy has been associated with a discontinuation syndrome, which may include vomiting, diarrhea, headaches, dizziness, chills, tremors, paresthesias, somnolence, fatigue, and sleep disturbances
May increase the risk of adverse effects associated with electroconvulsive therapy; discontinue therapy prior to electroconvulsive therapy if possible
Due to risk of drug interaction with anesthesia and of cardiac arrhythmia, discontinuation of therapy prior to elective surgery recommended
Association between treatment and the unmasking of Brugada syndrome with some resulting in death reported; therapy should generally be avoided in patients with Brugada syndrome or those suspected of having Brugada syndrome
Pregnancy & Lactation
Pregnancy category: D
Lactation: Excreted in breast milk; do not nurse (AAP states effect on nursing infants is unknown but may be of concern)
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Neurotransmitter (especially norepinephrine and serotonin) reuptake inhibitor; increases concentration of neurotransmitter in the CNS
Absorption
Onset of action: 1-3 weeks
Peak plasma time: 7-8.5 hr
Steady-state therapeutic plasma concentration: 50-150 ng/mL
Distribution
Protein bound: 93-95%
Vd: 21 L/kg
Metabolism
Hepatic CYP2D6
Elimination
Half-life: 28-31 hr
Excretion: Urine, feces
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
nortriptyline oral - | 50 mg capsule | ![]() | |
nortriptyline oral - | 25 mg capsule | ![]() | |
nortriptyline oral - | 10 mg capsule | ![]() | |
nortriptyline oral - | 25 mg capsule | ![]() | |
nortriptyline oral - | 25 mg capsule | ![]() | |
nortriptyline oral - | 75 mg capsule | ![]() | |
nortriptyline oral - | 10 mg capsule | ![]() | |
nortriptyline oral - | 50 mg capsule | ![]() | |
nortriptyline oral - | 10 mg capsule | ![]() | |
nortriptyline oral - | 25 mg capsule | ![]() | |
nortriptyline oral - | 75 mg capsule | ![]() | |
nortriptyline oral - | 50 mg capsule | ![]() | |
nortriptyline oral - | 50 mg capsule | ![]() | |
nortriptyline oral - | 75 mg capsule | ![]() | |
nortriptyline oral - | 10 mg capsule | ![]() | |
nortriptyline oral - | 75 mg capsule | ![]() | |
nortriptyline oral - | 10 mg/5 mL solution | ![]() | |
Pamelor oral - | 25 mg capsule | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
nortriptyline oral
NORTRIPTYLINE - ORAL
(nor-TRIP-ti-leen)
COMMON BRAND NAME(S): Aventyl, Pamelor
WARNING: Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition. Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.
USES: This medication is used to treat mental/mood problems such as depression. It may help improve mood and feelings of well-being, relieve anxiety and tension, and increase your energy level. This medication belongs to a class of medications called tricyclic antidepressants. It works by affecting the balance of certain natural chemicals (neurotransmitters) in the brain.
HOW TO USE: Read the Medication Guide provided by your pharmacist before you start taking nortriptyline and each time you get a refill. If you have any questions, consult your doctor or pharmacist.Take this medication by mouth as directed by your doctor, usually 1 to 4 times daily. If you are using the liquid form, measure the dose carefully using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects (such as dry mouth, dizziness), your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache, tiredness, and sleep change. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.This medication may not work right away. You may see some benefit within a week. However, it may take up to 4 weeks before you feel the full effect.Tell your doctor if your condition lasts or gets worse (such as your feelings of sadness get worse, or you have thoughts of suicide).
SIDE EFFECTS: See also Warning section.Drowsiness, dizziness, dry mouth, blurred vision, constipation, weight gain, or trouble urinating may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: heartburn that doesn't go away, shaking, mask-like facial expressions, muscle spasms, severe stomach/abdominal pain, decreased sexual ability/desire, enlarged/painful breasts.This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.Get medical help right away if you have any very serious side effects, including: severe dizziness, fast/irregular heartbeat, fainting, seizures, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: See also Warning section.Before taking nortriptyline, tell your doctor or pharmacist if you are allergic to it; or to other tricyclic antidepressants (such as amitriptyline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems, liver problems, recent heart attack, problems urinating (such as due to enlarged prostate), overactive thyroid (hyperthyroidism), personal or family history of glaucoma (angle-closure type), personal or family history of mental/mood conditions (such as bipolar disorder, psychosis), family history of suicide, seizures, conditions that may increase your risk of seizures (such as other brain disease, alcohol withdrawal).Nortriptyline may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using nortriptyline, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, Brugada syndrome, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using nortriptyline safely.This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.The liquid form of this medication may contain alcohol. Caution is advised if you have diabetes, alcohol dependence, liver disease, or any other condition that requires you to limit/avoid alcohol in your diet. Ask your doctor or pharmacist about using this product safely.If you have diabetes, this drug may make it harder to control your blood sugar levels. Monitor your blood sugar levels regularly and tell your doctor of the results. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Older adults may be more sensitive to the side effects of this drug, especially dry mouth, dizziness, confusion, difficulty urinating, and QT prolongation (see above).During pregnancy, this medication should be used only when clearly needed. Since untreated mental/mood problems (such as depression, anxiety, panic disorder) can be a serious condition, do not stop using this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: "blood thinners" (such as warfarin), disulfiram, thyroid supplements, certain drugs for high blood pressure (drugs that work in the brain such as clonidine, guanabenz).Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.Other medications can affect the removal of nortriptyline from your body, thereby affecting how nortriptyline works. These drugs include cimetidine, drugs to treat irregular heart rate (such as quinidine/propafenone/flecainide). This is not a complete list.Many drugs besides nortriptyline may affect the heart rhythm (QT prolongation in the EKG), including amiodarone, dofetilide, pimozide, procainamide, quinidine, sotalol, macrolide antibiotics (such as erythromycin), among others. Before using nortriptyline, report all medications you are currently using to your doctor or pharmacist.Tell your doctor or pharmacist if you are taking other products that cause drowsiness, including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain decongestants or ingredients that cause drowsiness. Ask your pharmacist about using those products safely.Nortriptyline is very similar to amitriptyline. Do not use medications containing amitriptyline while using nortriptyline.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: extreme drowsiness, hallucinations, fast/irregular heartbeat, fainting, slow/shallow breathing, seizures.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as EKG, liver function, nortriptyline blood level) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised August 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.