and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.ethinylestradiolethinylestradiol, 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.etomidateetomidate, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.eucalyptusnortriptyline and eucalyptus both increase sedation. Minor/Significance Unknown.fluphenazinenortriptyline, 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.glimepiridenortriptyline increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.glipizidenortriptyline increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.glyburidenortriptyline 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 aspartnortriptyline increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.insulin detemirnortriptyline increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.insulin glarginenortriptyline increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.insulin glulisinenortriptyline increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.insulin lispronortriptyline increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.insulin NPHnortriptyline increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.insulin regular humannortriptyline increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.isoproterenolisoproterenol, nortriptyline. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.ketamineketamine, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.lithiumlithium, nortriptyline. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.mestranolmestranol, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.metforminnortriptyline increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.miglitolnortriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.nateglinidenortriptyline increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.panax ginsengpanax ginseng increases effects of nortriptyline by pharmacodynamic synergism. Minor/Significance Unknown.pentobarbitalpentobarbital, 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.perphenazinenortriptyline, 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.phenobarbitalphenobarbital, 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.pioglitazonenortriptyline increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.pleurisy rootpleurisy root decreases effects of nortriptyline by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.primidoneprimidone, 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.prochlorperazinenortriptyline, 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 micronizedprogesterone 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.promazinenortriptyline, 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.promethazinenortriptyline, 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.propofolpropofol, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.repaglinidenortriptyline increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.rifampinrifampin decreases levels of nortriptyline by increasing metabolism. Minor/Significance Unknown.rosiglitazonenortriptyline increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.sagenortriptyline and sage both increase sedation. Minor/Significance Unknown.saxagliptinnortriptyline increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.secobarbitalsecobarbital, 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/dexmethylphenidateserdexmethylphenidate/dexmethylphenidate increases effects of nortriptyline by decreasing metabolism. Minor/Significance Unknown.sevofluranesevoflurane, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.sitagliptinnortriptyline increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.sulfamethoxazolesulfamethoxazole decreases levels of nortriptyline by unspecified interaction mechanism. Minor/Significance Unknown.thioridazinenortriptyline, 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.tolazamidenortriptyline increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.tolbutamidenortriptyline increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.trifluoperazinenortriptyline, 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.vasopressinnortriptyline increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.verapamilverapamil increases levels of nortriptyline by decreasing metabolism. Minor/Significance Unknown.vildagliptinnortriptyline increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.zolpidemzolpidem, nortriptyline. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.5-HTPMonitor Closely (1)nortriptyline and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abirateroneMonitor Closely (1)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.abobotulinumtoxinAMonitor Closely (1)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. .acarboseMinor (1)nortriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.aclidiniumMonitor Closely (1)aclidinium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.acrivastineMonitor Closely (1)acrivastine and nortriptyline both increase sedation. Use Caution/Monitor.adagrasibSerious - Use Alternative (1)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.albuterolMonitor Closely (2)albuterol and nortriptyline both increase QTc interval. Use Caution/Monitor. nortriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)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.alfentanilMonitor Closely (1)alfentanil and nortriptyline both increase sedation. Use Caution/Monitor.alfuzosinMonitor Closely (2)nortriptyline and alfuzosin both increase QTc interval. Use Caution/Monitor. alfuzosin and nortriptyline both increase QTc interval. Use Caution/Monitor.almotriptanMonitor Closely (1)almotriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.alprazolamMonitor Closely (1)alprazolam and nortriptyline both increase sedation. Use Caution/Monitor.amifampridineMonitor Closely (1)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.amiodaroneMonitor Closely (1)amiodarone will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)nortriptyline and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.amisulprideMonitor Closely (2)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.amitriptylineMonitor Closely (2)amitriptyline and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. amitriptyline and nortriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)amitriptyline and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. amitriptyline and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.amobarbitalMonitor Closely (1)amobarbital and nortriptyline both increase sedation. Use Caution/Monitor.Minor (1)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.amoxapineMonitor Closely (2)amoxapine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. amoxapine and nortriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)amoxapine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug. amoxapine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.anagrelideMonitor Closely (1)anagrelide and nortriptyline both increase QTc interval. Use Caution/Monitor.anticholinergic/sedative combosMonitor Closely (1)anticholinergic/sedative combos and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.apomorphineMonitor Closely (2)apomorphine and nortriptyline both increase QTc interval. Use Caution/Monitor. nortriptyline and apomorphine both increase sedation. Use Caution/Monitor.arformoterolMonitor Closely (2)arformoterol and nortriptyline both increase QTc interval. Use Caution/Monitor. nortriptyline increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)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.aripiprazoleMonitor Closely (2)aripiprazole and nortriptyline both increase QTc interval. Use Caution/Monitor. aripiprazole and nortriptyline both increase sedation. Use Caution/Monitor.armodafinilMonitor Closely (1)nortriptyline increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.arsenic trioxideSerious - Use Alternative (1)nortriptyline and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.artemetherSerious - Use Alternative (1)artemether and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineSerious - Use Alternative (2)nortriptyline and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug. artemether/lumefantrine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.asenapineMonitor Closely (3)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 transdermalMonitor Closely (2)asenapine transdermal and nortriptyline both increase QTc interval. Use Caution/Monitor. asenapine transdermal and nortriptyline both increase sedation. Use Caution/Monitor.atazanavirMonitor Closely (1)atazanavir increases levels of nortriptyline by unspecified interaction mechanism. Use Caution/Monitor.atomoxetineMonitor Closely (1)atomoxetine and nortriptyline both increase QTc interval. Use Caution/Monitor.atracuriumMonitor Closely (1)atracurium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.atropineMonitor Closely (1)atropine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.Minor (1)nortriptyline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.atropine IV/IMMonitor Closely (1)atropine IV/IM and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.Minor (1)nortriptyline increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.avapritinibMonitor Closely (1)avapritinib and nortriptyline both increase sedation. Use Caution/Monitor.azelastineMonitor Closely (1)azelastine and nortriptyline both increase sedation. Use Caution/Monitor.azithromycinMonitor Closely (1)nortriptyline and azithromycin both increase QTc interval. Use Caution/Monitor.baclofenMonitor Closely (1)baclofen and nortriptyline both increase sedation. Use Caution/Monitor.bazedoxifene/conjugated estrogensMinor (1)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.bedaquilineMonitor Closely (1)nortriptyline and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsMonitor Closely (1)belladonna alkaloids and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opiumMonitor Closely (2)belladonna and opium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. belladonna and opium and nortriptyline both increase sedation. Use Caution/Monitor.benperidolMonitor Closely (1)benperidol and nortriptyline both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (1)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.Serious - Use Alternative (1)benzhydrocodone/acetaminophen and nortriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebenzphetamineMonitor Closely (1)nortriptyline increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)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.benztropineMonitor Closely (1)benztropine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. bethanecholMonitor Closely (1)bethanechol increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.brexpiprazoleMonitor Closely (1)brexpiprazole and nortriptyline both increase sedation. Use Caution/Monitor.brimonidineMonitor Closely (1)brimonidine and nortriptyline both increase sedation. Use Caution/Monitor.Minor (1)nortriptyline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.brivaracetamMonitor Closely (1)brivaracetam and nortriptyline both increase sedation. Use Caution/Monitor.brompheniramineMonitor Closely (1)brompheniramine and nortriptyline both increase sedation. Use Caution/Monitor.buprenorphineMonitor Closely (1)buprenorphine and nortriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalMonitor Closely (1)buprenorphine buccal and nortriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine buccal and nortriptyline both increase