nortriptyline both increase sedation. Use Caution/Monitor.osilodrostatosilodrostat and nortriptyline both increase QTc interval. Use Caution/Monitor.osimertinibosimertinib 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.oxazepamoxazepam and nortriptyline both increase sedation. Use Caution/Monitor.oxybutyninoxybutynin and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin topicaloxybutynin topical and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin transdermaloxybutynin transdermal and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.oxycodoneoxycodone and nortriptyline both increase sedation. Use Caution/Monitor.oxymetazoline intranasalnortriptyline 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.oxymorphoneoxymorphone and nortriptyline both increase sedation. Use Caution/Monitor.ozanimodozanimod 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.paliperidonenortriptyline and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone and nortriptyline both increase sedation. Use Caution/Monitor.pancuroniumpancuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.papaveretumpapaveretum and nortriptyline both increase sedation. Use Caution/Monitor.papaverinenortriptyline and papaverine both increase sedation. Use Caution/Monitor.parecoxibparecoxib will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.paroxetinenortriptyline and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.pasireotidenortriptyline and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibnortriptyline and pazopanib both increase QTc interval. Use Caution/Monitor.peginterferon alfa 2bpeginterferon 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.pentazocinepentazocine and nortriptyline both increase sedation. Use Caution/Monitor.nortriptyline and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.pentobarbitalpentobarbital and nortriptyline both increase sedation. Use Caution/Monitor.perphenazineperphenazine 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.phendimetrazinenortriptyline increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenobarbitalphenobarbital and nortriptyline both increase sedation. Use Caution/Monitor.phenterminenortriptyline increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrinenortriptyline increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine ophthalmicnortriptyline, 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 POnortriptyline increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .pholcodinenortriptyline and pholcodine both increase sedation. Use Caution/Monitor.physostigminephysostigmine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pilocarpinepilocarpine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozidepimozide and nortriptyline both increase sedation. Use Caution/Monitor.pirbuterolnortriptyline increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.posaconazolenortriptyline and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.pralidoximepralidoxime and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.pregabalinpregabalin, 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.primidoneprimidone and nortriptyline both increase sedation. Use Caution/Monitor.prochlorperazineprochlorperazine and nortriptyline both increase QTc interval. Use Caution/Monitor.prochlorperazine and nortriptyline both increase sedation. Use Caution/Monitor.promethazinepromethazine and nortriptyline both increase QTc interval. Use Caution/Monitor.promethazine and nortriptyline both increase sedation. Use Caution/Monitor.propafenonepropafenone will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.propanthelinepropantheline and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.propofolpropofol and nortriptyline both increase sedation. Use Caution/Monitor.propylhexedrinenortriptyline increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylinenortriptyline and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.nortriptyline and protriptyline both increase sedation. Use Caution/Monitor.pyridostigminepyridostigmine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.quazepamquazepam and nortriptyline both increase sedation. Use Caution/Monitor.quetiapinequetiapine 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.quinacrinequinacrine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.quininenortriptyline and quinine both increase QTc interval. Use Caution/Monitor.ramelteonnortriptyline and ramelteon both increase sedation. Use Caution/Monitor.ranolazineranolazine 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.rapacuroniumrapacuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.remimazolamremimazolam, 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.rifabutinrifabutin decreases levels of nortriptyline by increasing metabolism. Use Caution/Monitor.rilpivirinerilpivirine 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.risperidonenortriptyline and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.risperidone and nortriptyline both increase sedation. Use Caution/Monitor.ritonavirritonavir will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.rizatriptanrizatriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.rocuroniumrocuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.romidepsinnortriptyline and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.salmeterolnortriptyline increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.SAMenortriptyline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.scopolaminescopolamine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.scullcapnortriptyline and scullcap both increase sedation. Use Caution/Monitor.secobarbitalsecobarbital and nortriptyline both increase sedation. Use Caution/Monitor.selpercatinibselpercatinib increases toxicity of nortriptyline by QTc interval. Use Caution/Monitor.sertralinesertraline will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely.sevofluranesevoflurane and nortriptyline both increase sedation. Use Caution/Monitor.sevoflurane and nortriptyline both increase QTc interval. Use Caution/Monitor.shepherd's pursenortriptyline and shepherd's purse both increase sedation. Use Caution/Monitor.sodium sulfate/?magnesium sulfate/potassium chloridesodium 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 glycolnortriptyline, 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 sulfatesodium 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.solifenacinsolifenacin and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.solifenacin and nortriptyline both increase QTc interval. Use Caution/Monitor.sorafenibsorafenib and nortriptyline both increase QTc interval. Use Caution/Monitor.stiripentolstiripentol, 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.succinylcholinesuccinylcholine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.sufentanilsufentanil and nortriptyline both increase sedation. Use Caution/Monitor.sufentanil SLsufentanil 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.sulfamethoxazolenortriptyline and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.sumatriptansumatriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.sumatriptan intranasalsumatriptan intranasal and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.suvorexantsuvorexant and nortriptyline both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessarytacrolimustacrolimus and nortriptyline both increase QTc interval. Use Caution/Monitor.tapentadoltapentadol and nortriptyline both increase sedation. Use Caution/Monitor.nortriptyline and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.telavancinnortriptyline and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.temazepamtemazepam and nortriptyline both increase sedation. Use Caution/Monitor.terbutalinenortriptyline increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tetrabenazinetetrabenazine and nortriptyline both increase QTc interval. Use Caution/Monitor.thioridazinethioridazine and nortriptyline both increase sedation. Use Caution/Monitor.thiothixenethiothixene and nortriptyline both increase sedation. Use Caution/Monitor.thyroid desiccatedthyroid 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.tiotropiumtiotropium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.tipranavirtipranavir will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.tolterodinetolterodine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.topiramatenortriptyline and topiramate both increase sedation. Modify Therapy/Monitor Closely.tramadoltramadol and nortriptyline both increase sedation. Use Caution/Monitor.nortriptyline and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.trazodonenortriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.nortriptyline and trazodone both increase sedation. Use Caution/Monitor.triazolamtriazolam and nortriptyline both increase sedation. Use Caution/Monitor.triclofostriclofos and nortriptyline both increase sedation. Use Caution/Monitor.trifluoperazinetrifluoperazine and nortriptyline both increase sedation. Use Caution/Monitor.trihexyphenidyltrihexyphenidyl and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.trimethoprimnortriptyline and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.trimipraminenortriptyline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.nortriptyline and trimipramine both increase sedation. Use Caution/Monitor.triprolidinetriprolidine and nortriptyline both increase sedation. Use Caution/Monitor.tropisetronnortriptyline and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.trospium chloridetrospium chloride and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.valbenazinevalbenazine and nortriptyline both increase QTc interval. Use Caution/Monitor.valerianvalerian and nortriptyline both increase sedation. Use Caution/Monitor.vecuroniumvecuronium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.venlafaxinenortriptyline and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.voclosporinvoclosporin, nortriptyline. Either increases effects of the other by QTc interval. Use Caution/Monitor.voriconazolenortriptyline and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.xylometazolinenortriptyline increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.yohimbinenortriptyline increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziconotidenortriptyline and ziconotide both increase sedation. Use Caution/Monitor.ziprasidoneziprasidone and nortriptyline both increase sedation. Use Caution/Monitor.zolmitriptanzolmitriptan and nortriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (71)acarbosenortriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.amobarbitalamobarbital, 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.atropinenortriptyline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.atropine IV/IMnortriptyline increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.bazedoxifene/conjugated estrogensbazedoxifene/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.brimonidinenortriptyline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.butabarbitalbutabarbital, 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.butalbitalbutalbital, 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.carbamazepinecarbamazepine decreases levels of nortriptyline by increasing metabolism. Minor/Significance Unknown.chlorpromazinenortriptyline, 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.chlorpropamidenortriptyline increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.conjugated estrogensconjugated 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, vaginalconjugated 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.desfluranedesflurane, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.dexmethylphenidatedexmethylphenidate increases effects of nortriptyline by decreasing metabolism. Minor/Significance Unknown.estradiolestradiol, 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 syntheticestrogens 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 esterifiedestrogens esterified, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens may inhibit hepatic metabolism of tricyclic antidepressants. However, interactions are not common.estropipateestropipate, nortriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens