AdultPediatricGeriatricDosage 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 rateDosage 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 lessDepression Initial: 30-50 mg PO qDay or in divided doses May increase to 75-100 mg/day if toleratedInteraction CheckerEnter a drug name and nortriptylineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (17)disopyramidenortriptyline and disopyramide both increase QTc interval. Contraindicated.dronedaronedronedarone will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.ibutilidenortriptyline and ibutilide both increase QTc interval. Contraindicated.indapamidenortriptyline and indapamide both increase QTc interval. Contraindicated.iobenguane I 123nortriptyline 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.isocarboxazidisocarboxazid and nortriptyline both increase serotonin levels. Contraindicated.pentamidinenortriptyline and pentamidine both increase QTc interval. Contraindicated.phenelzinephenelzine and nortriptyline both increase serotonin levels. Contraindicated.pimozidenortriptyline and pimozide both increase QTc interval. Contraindicated.procainamidenortriptyline and procainamide both increase QTc interval. Contraindicated.procarbazineprocarbazine and nortriptyline both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.quinidinequinidine and nortriptyline both increase QTc interval. Contraindicated.safinamidenortriptyline, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.selegilineselegiline and nortriptyline both increase serotonin levels. Contraindicated. Concurrent use or use within 14 days of selegiline treatment is contraindicatedsotalolnortriptyline and sotalol both increase QTc interval. Contraindicated.thioridazinethioridazine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.tranylcyprominetranylcypromine and nortriptyline both increase serotonin levels. Contraindicated.Serious - Use Alternative (143)adagrasibadagrasib, 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.albuterolnortriptyline, 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.amiodaronenortriptyline and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.amitriptylineamitriptyline and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.amoxapineamoxapine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.amoxapine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.arformoterolnortriptyline, 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 trioxidenortriptyline and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.artemetherartemether and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineartemether/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/acetaminophenbenzhydrocodone/acetaminophen and nortriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebenzphetaminenortriptyline, 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.buprenorphinebuprenorphine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalbuprenorphine buccal and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantbuprenorphine 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 inadequatebuprenorphine transdermalbuprenorphine 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 inadequatebuprenorphine, long-acting injectionbuprenorphine, 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 inadequatebuspironenortriptyline and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.calcium/magnesium/potassium/sodium oxybatesnortriptyline, 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.chlorpromazinechlorpromazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.citalopramcitalopram 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.clarithromycinnortriptyline and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.clomipramineclomipramine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.clomipramine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.clonidinenortriptyline decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.cyclobenzaprinenortriptyline and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.dacomitinibdacomitinib 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. desipraminedesipramine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.desipramine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.desvenlafaxinenortriptyline and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.dexfenfluraminenortriptyline, 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.dexmethylphenidatenortriptyline, 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.dextroamphetaminenortriptyline, 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.dextromethorphannortriptyline and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.diethylpropionnortriptyline, 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.dobutaminenortriptyline, 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.dofetilidenortriptyline and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.dofetilide increases toxicity of nortriptyline by QTc interval. Avoid or Use Alternate Drug.dolasetrondolasetron, nortriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.dopaminenortriptyline, 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.dopexaminenortriptyline, 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.doxepindoxepin and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.doxepin and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.dronedaronenortriptyline and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.droperidolnortriptyline and droperidol both increase QTc interval. Avoid or Use Alternate Drug.duloxetineduloxetine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.elvitegravir/cobicistat/emtricitabine/tenofovir DFelvitegravir/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.encorafenibencorafenib and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.ephedrinenortriptyline, 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.epinephrineepinephrine 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 racemicepinephrine 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 basenortriptyline and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.erythromycin ethylsuccinatenortriptyline and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin lactobionatenortriptyline and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.erythromycin stearatenortriptyline and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.escitalopramescitalopram and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.fenfluraminenortriptyline, 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.fexinidazolefexinidazole 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.fluconazolenortriptyline and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.fluoxetinefluoxetine 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.fluphenazinefluphenazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.fluvoxaminefluvoxamine and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.formoterolnortriptyline 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.fosamprenavirfosamprenavir increases levels of nortriptyline by decreasing metabolism. Avoid or Use Alternate Drug.givosirangivosiran 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.granisetrongranisetron, nortriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.guanfacinenortriptyline decreases effects of guanfacine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.haloperidolhaloperidol 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 sulfatehydroxychloroquine sulfate and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.imipramineimipramine 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 131nortriptyline will decrease the level or effect of iobenguane I 131 by Other (see