Drug interactions
Asenapine + Nortriptyline
Severity: Moderate
Asenapine and Nortriptyline: moderate 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
Asenapine is a weak CYP2D6 inhibitor and may raise nortriptyline levels. Both drugs also prolong the QT interval and cause sedation, which may increase arrhythmia and CNS depression risk.
What this interaction means in plain words
Asenapine and Nortriptyline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Asenapine belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Weak CYP2D6 inhibition by asenapine plus additive QT prolongation and CNS depression.
What to do
Monitor the ECG and sedation, and consider nortriptyline levels or dose reduction if toxicity appears. Correct electrolyte disturbances.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline Contraindicated
Other interactions of Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine Major
Frequently asked questions
Can I take Asenapine with Nortriptyline?
MediHelp rates the interaction as moderate. Asenapine and Nortriptyline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Asenapine is a weak CYP2D6 inhibitor and may raise nortriptyline levels. Both drugs also prolong the QT interval and cause sedation, which may increase arrhythmia and CNS depression risk.
How serious is the interaction between Asenapine and Nortriptyline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor the ECG and sedation, and consider nortriptyline levels or dose reduction if toxicity appears. Correct electrolyte disturbances.
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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