Drug interactions
Amoxapine + Nortriptyline
Severity: Major
Amoxapine and Nortriptyline: major interaction.
Last updated Sources: US FDA label
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
Combining two tricyclic-type antidepressants duplicates therapy and adds QT prolongation, anticholinergic burden, sedation and seizure risk. Serotonergic toxicity is possible as well.
What this interaction means in plain words
Amoxapine 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.
Why it happens
Additive monoamine reuptake inhibition, muscarinic blockade and effects on cardiac conduction.
What to do
Avoid using both and consolidate to a single agent. When switching, cross-taper gradually and monitor the ECG and for anticholinergic or serotonergic signs.
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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References
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 Amoxapine with Nortriptyline?
MediHelp rates the interaction as major. Amoxapine 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. Combining two tricyclic-type antidepressants duplicates therapy and adds QT prolongation, anticholinergic burden, sedation and seizure risk. Serotonergic toxicity is possible as well.
How serious is the interaction between Amoxapine 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: Avoid using both and consolidate to a single agent. When switching, cross-taper gradually and monitor the ECG and for anticholinergic or serotonergic signs.
What other medicines interact with Nortriptyline?
MediHelp also lists interactions of Nortriptyline with, for example, Disopyramide, Dofetilide, Dronedarone. The full list is on the Nortriptyline page.
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