Drug interactions
Amiodarone + Nortriptyline
Severity: Major
Amiodarone and Nortriptyline: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Nortriptyline can prolong QT and slow intraventricular conduction, and amiodarone adds to these effects. The combination increases the risk of torsades de pointes and may raise nortriptyline levels.
What this interaction means in plain words
Amiodarone and Nortriptyline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation and conduction delay; amiodarone may inhibit CYP2D6 metabolism of nortriptyline.
What to do
Prefer a different antidepressant. If combined, check a baseline ECG, monitor QTc and consider nortriptyline levels and dose reduction.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Other interactions of Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Frequently asked questions
Can I take Amiodarone with Nortriptyline?
MediHelp rates the interaction as major. Amiodarone and Nortriptyline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Nortriptyline can prolong QT and slow intraventricular conduction, and amiodarone adds to these effects. The combination increases the risk of torsades de pointes and may raise nortriptyline levels.
How serious is the interaction between Amiodarone and Nortriptyline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a different antidepressant. If combined, check a baseline ECG, monitor QTc and consider nortriptyline levels and dose reduction.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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