Drug interactions
Asenapine transdermal + Nortriptyline
Severity: Moderate
Asenapine transdermal 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
Both drugs can prolong the QT interval and cause sedation, so combined use may raise arrhythmia risk and impair alertness. Asenapine also inhibits CYP2D6 weakly, which may modestly increase nortriptyline levels.
What this interaction means in plain words
Asenapine transdermal 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.
Why it happens
Additive QTc prolongation and CNS depression; possible CYP2D6 inhibition.
What to do
Obtain a baseline ECG and monitor QTc, and correct electrolytes. Monitor for sedation and tricyclic toxicity, adjusting doses as needed.
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
Frequently asked questions
Can I take Asenapine transdermal with Nortriptyline?
MediHelp rates the interaction as moderate. Asenapine transdermal 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. Both drugs can prolong the QT interval and cause sedation, so combined use may raise arrhythmia risk and impair alertness. Asenapine also inhibits CYP2D6 weakly, which may modestly increase nortriptyline levels.
How serious is the interaction between Asenapine transdermal 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: Obtain a baseline ECG and monitor QTc, and correct electrolytes. Monitor for sedation and tricyclic toxicity, adjusting doses as needed.
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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