Drug interactions
Atomoxetine + Nortriptyline
Severity: Moderate
Atomoxetine 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 may prolong the QT interval, and atomoxetine can raise heart rate and blood pressure. Nortriptyline is a CYP2D6 substrate, and atomoxetine is also metabolized by CYP2D6, so competition may occur. Arrhythmia risk is higher in patients with cardiac disease.
What this interaction means in plain words
Atomoxetine 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.
Atomoxetine belongs to Central Nervous System; Nortriptyline belongs to Central Nervous System.
Why it happens
Additive QT prolongation and noradrenergic effects, with possible competition at CYP2D6.
What to do
Monitor ECG, heart rate and blood pressure, and watch for tricyclic adverse effects. Avoid in patients with known QT prolongation or significant cardiac disease.
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 Atomoxetine
- Atomoxetine + Isocarboxazid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Atomoxetine + Rasagiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Atomoxetine with Nortriptyline?
MediHelp rates the interaction as moderate. Atomoxetine 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 may prolong the QT interval, and atomoxetine can raise heart rate and blood pressure. Nortriptyline is a CYP2D6 substrate, and atomoxetine is also metabolized by CYP2D6, so competition may occur. Arrhythmia risk is higher in patients with cardiac disease.
How serious is the interaction between Atomoxetine 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 ECG, heart rate and blood pressure, and watch for tricyclic adverse effects. Avoid in patients with known QT prolongation or significant cardiac disease.
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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