Drug interactions
Belladonna and opium + Nortriptyline
Severity: Moderate
Belladonna and opium 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
Nortriptyline has strong anticholinergic activity, and belladonna adds further antimuscarinic effect while opium contributes opioid sedation. Together they can cause marked drowsiness, constipation, urinary retention, dry mouth and confusion, particularly in older adults, and the combination may lead to paralytic ileus.
What this interaction means in plain words
Belladonna and opium 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 antimuscarinic effects plus additive CNS depression from the opioid component and the tricyclic antidepressant.
What to do
Monitor for sedation, urinary retention and constipation, and use the lowest effective doses, especially in older patients. Consider a different analgesic or antispasmodic if anticholinergic toxicity develops.
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 Belladonna and opium with Nortriptyline?
MediHelp rates the interaction as moderate. Belladonna and opium 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. Nortriptyline has strong anticholinergic activity, and belladonna adds further antimuscarinic effect while opium contributes opioid sedation. Together they can cause marked drowsiness, constipation, urinary retention, dry mouth and confusion, particularly in older adults, and the combination may lead to paralytic ileus.
How serious is the interaction between Belladonna and opium 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 for sedation, urinary retention and constipation, and use the lowest effective doses, especially in older patients. Consider a different analgesic or antispasmodic if anticholinergic toxicity develops.
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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